Abstract: Objective The aim of this study was to investigate vasovagal reaction (VVR) in patients with liver failure (LF) during double plasma molecular adsorption system (DPMAS) treatment. Methods 82 patients with LF and 17 patients with pre-LF were encountered in our hospital between January 2021 and March 2022, and all underwent DPMAS treatment. The VVR was defined as decreased blood pressure and slowed heart beats with concomitant symptoms. Results Out of the 99 patients with LF or pre-LF, the incidence of VVR was 3.1% in 417 times of DPMAS from 8 patients; before the DPMAS treatment, the systolic blood pressure, heart beats and venous pressure in patients with VVR were (105.7±8.7) mmHg, (71.3±11.2) bpm and (3.5±7.3)mmHg, all significantly lower or slower than [(114.6±14.7) mmHg, (82.7±15.0)bpm and (14.7±16.5)mmHg, respectively, P＜0.05] in patients without VVR, while there were no significant differences as respect to the diastolic pressure, mean arterial pressure, arterial pressure and transmembrane pressure between the two groups(P>0.05); the incidence of VVR was 5.7% in patients with SBP≤110 mmHg before DPMAS, accounting for 76.9% of all, while the VVR was 1.2% in patients with SBP＞110 mmHg, accounting for 23.1% of all; in all patients with VVR, the DPMAS was discontinued, administered with hydroxyethyl starch sodium chloride intravenously, and all recovered; the prophylactic infusion of hydroxyethyl starch sodium chloride intravenously in patients with SBP≤110 mmHg before DPMAS decreased the incidence of VVR. Conclusions The DPMAS treatment-related VVR is a relatively rare complication, and the decreased SBP and slow HR before treatment are the important factors impacting the occurrence of VVR. The intravenous infusion of hydroxyethyl starch sodium chloride is the main measure to prevent the occurrence of VVR.

Key words: Liver failure, Double plasma molecular adsorption system, Vasovagal reaction, Therapy