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Molecular Adsorbent Recirculating System (MARS™ en réanimation pédiatrique

Molecular Adsorbent Recirculating System (MARS™) in pediatric intensive care unit

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Réanimation

Résumé

L’insuffisance hépatique est une situation grave, avec une menace vitale. La mortalité qui lui est associée reste haute, principalement en raison de l’encéphalopathie. Un support extracorporel, tel que le Molecular Adsorbant Recirculating System (MARS™), permet d’épurer des molécules liées à l’albumine et hydrosolubles, qui sont associées à l’encéphalopathie.

Plusieurs études cas-contrôles et quelques études randomisées contrôlées chez l’adulte ont montré une amélioration du devenir, tant en termes de morbidité que de mortalité, pour les patients traités par MARS™. Néanmoins, il n’y a que très peu de données chez l’enfant. D’autres questions sont encore en suspens, comme le moment optimal pour introduire ce traitement ou la comparaison entre le MARS™ et d’autres techniques, telles que l’hémofiltration à haut débit.

Nous allons passer en revue les informations actuelles sur le MARS™ chez les adultes et les enfants admis en réanimation.

Abstract

Pediatric liver failure is a severe and life-threatening condition. Its mortality rate remains high, mainly due to encephalopathy. Extracorporeal liver supports, such as Molecular Adsorbant Recirculating System (MARS™), allow for safe and effective removal of albumin-bound and water-soluble substances, suspected of being responsible for the encephalopathy. Several small randomized controlled trials and case control studies in adults showed significant improvement, both in morbidity and mortality, in patients treated with MARS™. However, similar data is missing for children. In addition, many questions remain, such as the appropriate timing of MARS™ treatment and its efficacy compared to other treatments, such as high-flow hemofiltration.

We are going to review the current information regarding MARS™ treatment in adults and children.

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  1. Unité de soins intensifs pédiatriques, département de pédiatrie, hôpitaux universitaires de Genève, Genève, Suisse

    A. Hagerman & O. Karam

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  1. A. Hagerman
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  2. O. Karam
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Correspondence to O. Karam.

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Hagerman, A., Karam, O. Molecular Adsorbent Recirculating System (MARS™ en réanimation pédiatrique. Réanimation 25, 239–245 (2016). https://doi.org/10.1007/s13546-015-1162-3

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  • DOI: https://doi.org/10.1007/s13546-015-1162-3

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