Bottari Gabriella, Moscatelli Andrea, Verrina Enrico E, Lerzo Franco, Taccone Fabio S
Neonatal and Pediatric Intensive Care Unit, Giannina Gaslini Institute, Genoa - Italy.
Dialysis Unit, Giannina Gaslini Institute, Genoa - Italy.
Int J Artif Organs. 2017 Sep 15;40(9):522-525. doi: 10.5301/ijao.5000615. Epub 2017 Jun 20.
Hyperbilirubinemia may have deleterious effects on many organs, even after the neonatal age. Blood purification is effective in the treatment of hyperbilirubinemia. Recently some reports suggest the potential role of hemoadsorption columns in this setting.
We present the case of a 6-year-old child with severe hyperbilirubinemia due to congestive liver dysfunction, complicated by persistent inflammation, immunosuppression and catabolism syndrome (PICS). The patient was treated with a hemoadsorption column (Lixelle®) in combination with continuous veno-venous hemodiafiltration (CVVHDF).
During treatment, a significant and rapid decrease in total bilirubin (TB) and other indices of cholestasis was observed. Furthermore, a progressive reduction in the inflammatory biomarkers (Procalcitonin, C-reactive protein) occurred. These results persisted at the discontinuation of therapy.
To our knowledge this is the first case in which hemoadsorption with the Lixelle® adsorbing column in combination with CVVHDF has been used to manage pediatric hyperbiliribinemia secondary to cardiogenic liver injury.
高胆红素血症即使在新生儿期过后，也可能对许多器官产生有害影响。血液净化在高胆红素血症的治疗中有效。最近一些报告表明血液吸附柱在这种情况下具有潜在作用。
我们报告一例6岁儿童，因充血性肝功能障碍导致严重高胆红素血症，并伴有持续炎症、免疫抑制和分解代谢综合征（PICS）。该患者接受了血液吸附柱（Lixelle®）联合连续性静脉-静脉血液透析滤过（CVVHDF）治疗。
治疗期间，观察到总胆红素（TB）和其他胆汁淤积指标显著快速下降。此外，炎症生物标志物（降钙素原、C反应蛋白）逐渐降低。这些结果在治疗停止后仍持续存在。
据我们所知，这是首例使用Lixelle®吸附柱血液吸附联合CVVHDF治疗心源性肝损伤继发小儿高胆红素血症的病例。
