OBJECTIVE: Acute liver failure (ALF) is a rare disease with a bad prognosis. Its start is accompanied by haemodynamic instability. The aim of our study was to evaluate the influence of fractionated plasmatic separation and adsorption (FPSA) on body haemodynamics using a large animal experimental model of ALF. METHODS: ALF was induced by the devascularisation of 21 laboratory pigs. FPSA was applied in 14 animals and seven animals formed a control group. Values of systemic vascular resistance index (SVRI), heart rate (HR), pulmonary artery wedge pressure (PAWP) and cardiac index (CI) at hours 3, 6, 9 and 12 of the experiment were compared. The values from laboratory tests conducted with FPSA-treated vs. untreated ALF animals were compared using Student's t-test, paired or unpaired, as required, and Mann-Whitney U-test using EXCEL and QUATRO spreadsheet applications. RESULTS: We found no significant differences in mean arterial pressure, SVRI, or plasma lactate (p>0.05) in the FPSA-treated group but there was a significant decrease(p<0.05) in intracranial pressure (ICP). Furthermore, we observed a significant decrease in HR at hour 3. A significant increase in CI at hour 9 and a significant decrease in pulmonary artery wedge pressure at hours 6 and 12 were also observed. CONCLUSION: Our study of FPSA application (Prometheus device) for treatment of experimental ALF in a large animal model did not confirm the earlier reported development of changes in body haemodynamics.

Anaesthesiology Resuscitation and Intensive Care Clinic 2nd Faculty of Medicine Charles University Prague Czech Republic

Department of Anaesthesiology Resuscitation and Intensive Care 1st Faculty of Medicine and General Faculty Hospital Charles University Prague Czech Republic

Department of Surgery 2nd Faculty of Medicine Charles University and Central Military Hospital Prague Czech Republic