Extracorporeal Circulation in Hypothermia as Used for Total-Body Washout in Stage IV Hepatic Coma

Abstract The rapid infusion of a refrigerated, buffered albumin electrolyte solution combined with simultaneous exsanguination (total-body washout) is designed to remove the circulating neurotoxic substances that are associated with hepatic coma. This technique thereby permits time for liver regeneration by delaying the patient's death due to progressive encephalopathy. This safe, simple procedure also promptly controls bleeding problems, helps to stabilize blood pressure, and promotes diuresis. No serious complications have been observed, and the procedure now seems indicated when conventional forms of therapy fail to control progressive hepatic coma.