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    The role of the ADVanced Organ Support (ADVOS) system in critically ill patients with multiple organ failure

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    Author
    Acharya, Metesh
    Keyword
    ADVanced Organ Support
    albumin dialysis
    extracorporeal organ support
    multiple organ failure
    multiple organ support
    Date
    2022
    
    Metadata
    Show full item record
    Publisher's URL
    https://onlinelibrary.wiley.com/doi/10.1111/aor.14188
    Abstract
    Background: Multi-organ failure characterized by acute kidney injury, liver dysfunction, and respiratory failure is a complex condition associated with high mortality, for which multiple individual support devices may be simultaneously required. This review aims to appraise the current evidence for the ADVanced Organ Support (ADVOS) system, a novel device integrating liver, lung, and kidney support with blood detoxification. Methods: We performed a literature review of the PubMed database to identify human and animal studies evaluating the ADVOS system. Results: In porcine models of acute liver injury and small clinical studies in humans, ADVOS significantly enhanced the elimination of water-soluble and protein-bound toxins and metabolites, including creatinine, ammonia, blood urea nitrogen, and lactate. Cardiovascular parameters (mean arterial pressure, cerebral perfusion pressure, and cardiac index) and renal function were improved. ADVOS clears carbon dioxide (CO2 ) effectively with rapid correction of pH abnormalities, achieving normalization of CO2 , and bicarbonate levels. In patients with COVID-19 infection, ADVOS enables rapid correction of acid-base disturbance and respiratory acidosis. ADVOS therapy reduces mortality in multi-organ failure and has been shown to be safe with minimal adverse events. Conclusions: From the small observational studies analyzed, ADVOS demonstrates excellent detoxification of water-soluble and protein-bound substances. In particular, ADVOS permits the correction of metabolic and respiratory acidosis through the fluid-based direct removal of acid and CO2 . ADVOS is associated with significant improvements in hemodynamic and biochemical parameters, a trend toward improved survival in multi-organ failure, and is well-tolerated. Larger randomized trials are now necessary to further validate these encouraging results.
    Citation
    Acharya, M., Berger, R., & Popov, A. F. (2022). The role of the ADVanced Organ Support (ADVOS) system in critically ill patients with multiple organ failure. Artificial organs, 10.1111/aor.14188. Advance online publication. https://doi.org/10.1111/aor.14188
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/15223
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    Cardiac Surgery

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