{"id":28324,"date":"2025-08-28T04:05:00","date_gmt":"2025-08-27T20:05:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=28324"},"modified":"2025-08-28T17:12:03","modified_gmt":"2025-08-28T09:12:03","slug":"icu-management-practice-%e6%85%a2%e6%80%a7%e8%82%9d%e5%8a%9f%e8%83%bd%e8%a1%b0%e7%ab%ad%e6%80%a5%e6%80%a7%e5%8a%a0%e9%87%8d%e6%82%a3%e8%80%85%e7%9a%84%e8%a1%80%e6%b5%86%e4%ba%a4%e6%8d%a2","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=28324","title":{"rendered":"[ICU Management &#038; Practice]: \u6162\u6027\u809d\u529f\u80fd\u8870\u7aed\u6025\u6027\u52a0\u91cd\u60a3\u8005\u7684\u8840\u6d46\u4ea4\u6362"},"content":{"rendered":"\n<h1 class=\"wp-block-heading\">Therapeutic Plasma Exchange in Patients With Acute-On-Chronic Liver Failure<\/h1>\n\n\n\n<ul>\n<li>In&nbsp;<a href=\"https:\/\/healthmanagement.org\/c\/icu\">ICU<\/a><\/li>\n\n\n\n<li>Mon, 28 Apr 2025<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/res.cloudinary.com\/healthmanagement-org\/image\/upload\/c_thumb,f_auto,fl_lossy,q_90\/v1745846951\/cw\/00129929_cw_image_wi_a5ef20c59444581fe566d95eb50c6954.webp\" alt=\"\"\/><\/figure>\n\n\n\n<p>Acute-on-chronic liver failure is a serious syndrome characterised by the development of organ failure following an acute hepatic insult and is associated with high short-term mortality rates. Plasma exchange has emerged as a potential treatment option for patients with acute-on-chronic liver failure.&nbsp;<\/p>\n\n\n\n<p><br \/>A recent systematic review and meta-analysis aimed to evaluate the efficacy of plasma exchange compared to standard medical therapy in improving survival outcomes among acute-on-chronic liver failure patients across various definitions and aetiologies.<\/p>\n\n\n\n<p>The analysis included 23 studies encompassing 5336 patients (2724 in the plasma exchange group), with four studies being randomised controlled trials. Using the Mantel-Haenszel method within a random-effects model, the primary outcome assessed was 30-day survival. Plasma exchange treatment was associated with a significant reduction in 30-day mortality and 90-day mortality. Further analysis of six studies (1495 patients, including two randomised controlled trials) demonstrated improved one-year survival in the plasma exchange group.&nbsp;<\/p>\n\n\n\n<p>Subgroup analyses showed significant survival benefits with plasma exchange in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure and alcohol-related acute-on-chronic liver failure at 90 days. Additionally, plasma exchange improved three-month survival across different acute-on-chronic liver failure definitions. The most commonly reported adverse effects of plasma exchange were skin rash and allergic reactions, occurring in approximately 14% of patients.<\/p>\n\n\n\n<p>In conclusion, this comprehensive and up-to-date meta-analysis demonstrates that plasma exchange offers significant survival benefits at one, three, and 12 months compared to standard medical therapy in patients with acute-on-chronic liver failure. These findings support the growing role of plasma exchange as an effective therapeutic strategy in the management of acute-on-chronic liver failure.<\/p>\n\n\n\n<p>Source:&nbsp;<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/liv.70018\" target=\"_blank\" rel=\"noreferrer noopener\">Liver International<\/a><\/p>\n\n\n\n<p>Image Credit: iStock<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">References:<\/h4>\n\n\n\n<p>Kumar SE, Sithamparapillai K, Choudhury AK, Bharadwaj PK, Trebicka J, Karvellas CJ, Arab JP, Premkumar PS, Eapen CE, Goel A.&nbsp;<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/liv.70018\" target=\"_blank\" rel=\"noreferrer noopener\">Therapeutic Plasma Exchange in Patients With Acute-On-Chronic Liver Failure Improves Survival-An Updated Meta-Analysis.<\/a>&nbsp;Liver Int. 2025 May;45(5):e70018.&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Therapeutic Plasma Exchange in Patients With Acute-On-C [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[24,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28324"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=28324"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28324\/revisions"}],"predecessor-version":[{"id":28325,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28324\/revisions\/28325"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=28324"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=28324"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=28324"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}