Comparison of Two Artificial Liver Treatments for Acute Liver Failure: A Retrospective Observational Study.
Xiulian Wu, Dongxia Wu, Xiaoqing Sun and 4 others
PMID 41655000WHAT IT FOUND
Plasma exchange alone had lower total bilirubin and lower INR after treatment than dual plasma molecular adsorption plus plasma exchange, while the dual treatment had more adverse events.
The authors still favoured dual treatment for bilirubin.
Key findings
01After treatment, total bilirubin was 237.91 ± 124.34 in the plasma exchange group and 297.95 ± 153.38 in the dual plasma molecular adsorption plus plasma exchange group, although the authors stated the dual treatment improved bilirubin better.
02After treatment, INR was 1.66 ± 0.72 in the plasma exchange group and 1.84 ± 0.66 in the dual plasma molecular adsorption plus plasma exchange group, and the paper reported less coagulation improvement in the dual group.
03Adverse reactions were reported in 9.30% of dual plasma molecular adsorption plus plasma exchange treatments and 7.14% of plasma exchange treatments.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was single-centre and retrospective, and clinicians chose the treatment rather than using random assignment, so differences between groups could reflect patient selection. The plasma exchange group was small (14 patients), and the authors said this could bias the statistical results. The paper did not state a clear primary outcome, and the bilirubin result and the authors' interpretation were inconsistent.
Declared interests
Funding came from Beijing You'an Hospital projects, including a nursing research project. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that dual plasma molecular adsorption plus plasma exchange is clearly better for liver failure. The paper reported lower total bilirubin and lower INR after plasma exchange alone, and the treatment was chosen by clinicians rather than randomly assigned in a small retrospective study.