Assessing treatment efficiency in patients with hepatic encephalopathy

Abstract

Aim. Comparative analysis of the efficacy of conservative and extracorporeal methods of treatment in patients with hepatic encephalopathy. Methods. The study included 117 patients with chronic liver failure. In all patients hepatic encephalopathy, registered in 100% of cases, was one of the major syndromes, with its severity ranging from stage 2 to 4. All patients were distributed to 4 groups, conservative treatment was continued in all groups. In the 2nd group plasma exchange, in 3rd - plasma exchange + high volume venovenous hemofiltration, in 4th - Molecular Adsorbent Recirculating System (MARS) were added. Treatment effect was assessed by the number of patients with positive changes in mental status (assessed by number connection test) and by the number of patients with varying degrees of hepatic encephalopathy regression (in points). Results. Data analysis showed that both conservative and extracorporeal methods of treatment leaded to the reduction of hepatic encephalopathy severity, as well as better results in number connection test, but the improvement was more significant in patients treated with extracorporeal methods. Among them, better effect was seen in patients treated with Molecular Adsorbent Recirculating System use. At the time of discharge, no signs of deterioration was seen in patients treated by Molecular Adsorbent Recirculating System and plasma exchange + high volume venovenous hemofiltration. Conclusion. Extracorporeal methods of treatment are more effective for hepatic encephalopathy severity reduction compared to conservative therapy, Molecular Adsorbent Recirculating System is the most effective method compared to other extracorporeal methods.