Extracorporeal Cation‐exchange Circuits in the Treatment of Hyperammonæmia of Hepatic Failure

A technique of extracorporeal circulation through cation-exchange circuits was developed and preliminary experience with four clinical perfusions in the treatment of hyperammonæmia of hepatic failure is described. A mixture (mixture “G”) of the sodium, potassium, calcium and magnesium forms of the strong cation-exchange resin, Amberlite IR-120, with a total quantity of 750 mEq was used in the perfusion columns instead of the sodium form of the resin.' This mixture has been shown to be effective in the correction of hyperammonæmia of three patients with hepatic failure. There were no adverse effects of the perfusions and other cationic constituents of the perfused blood were not significantly altered. Some improvement in clinical status of the patients was observed and coma was sufficiently reversed in two of the three patients. Selection of suitable patients has been emphasized for getting a striking and persistent clinical response. The perfusion technique is simple, easily operable and inexpensive and can be assembled at the bedside of the patients. Furthermore, results have been encouraging enough to recommend that this method be tried by others for its proper evaluation.