Aplicabilidad de la terapia MARS en pacientes con patología hepática

• Autores: Gema Girón Poves, Pablo Ruiz García, Miriam Infante Garza, César Leal Costa , José Luis Díaz Agea
• Localización: Metas de enfermería, ISSN 1138-7262, Vol. 21, Nº. 6, 2018, págs. 58-62
• Idioma: español
• DOI: 10.35667/metasenf.2019.21.1003081262
• Títulos paralelos:
  • Applicability of the MARS Therapy in patients with hepatic conditions
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• Resumen
  • español

    Objetivo: identificar las indicaciones de la terapia MARS en pacientes con fallo hepático o insuficiencia hepática.

    Método: revisión narrativa de artículos publicados en el periodo 2012-2017 en las bases de datos bibliográficas Pubmed, Web of Science y Cochrane, que evaluarán el éxito del tratamiento de la terapia MARS en pacientes con fallo hepático o insuficiencia hepática. Se incluyeron ensayos clínicos, estudios observacionales y estudios de caso. Se excluyeron los estudios transversales.

    Resultados: se seleccionaron 13 artículos: ocho ensayos clínicos y cinco estudios de caso. La terapia MARS se aplicó en pacientes con fallo hepático sin etiología específica, asociado a intoxicaciones, complicado con encefalopatía hepática; en sujetos que además tenían insuficiencia cardiopulmonar y estaban conectados a ECMO (oxigenación por membrana extracorpórea), en pacientes en lista de espera para trasplante o postrasplantados.

    Conclusión: se detectaron ciertas controversias en la aplicación de terapia MARS en pacientes con fallo hepático o insuficiencia hepática. La indicación más respaldada por los estudios revisados en la aplicación de la terapia MARS es en el caso de los pacientes en lista de espera para trasplante hepático.

  • English

    Objective: to identify the indications of MARS therapy in patients with liver failure or impairment.

    Method: a narrative review of articles published from 2012 to 2017 in the bibliographic databases Pubmed, Web of Science and Cochrane, evaluating treatment success for MARS therapy in patients with liver failure or impairment. Clinical trials, observational studies and case studies were included; while cross-sectional studies were excluded.

    Results: thirteen (13) articles were selected: eight clinical trials and five case studies. MARS therapy was applied in patients with renal failure without a specific etiology, associated with intoxications, with liver encephalopathy as complication; in subjects who also presented cardiopulmonary failure and were connected to ECMO (extra-corporeal membrane oxygenation), in patients on the waiting list for transplant, or after undergoing transplant.

    Conclusion: certain controversies were detected regarding the application of MARS therapy in patients with liver failure or impairment. The indication with the highest support by the studies reviewed regarding the application of MARS therapy was the case of patients in the waiting list for a liver transplant.

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