{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:14:07Z","timestamp":1790104447824,"version":"4.0.1"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,2,6]],"date-time":"2022-02-06T00:00:00Z","timestamp":1644105600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,2,6]],"date-time":"2022-02-06T00:00:00Z","timestamp":1644105600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multi\u2010organ failure characterized by acute kidney injury, liver dysfunction, and respiratory failure is a complex condition associated with high mortality, for which multiple individual support devices may be simultaneously required. This review aims to appraise the current evidence for the ADVanced Organ Support (ADVOS) system, a novel device integrating liver, lung, and kidney support with blood detoxification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a literature review of the PubMed database to identify human and animal studies evaluating the ADVOS system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In porcine models of acute liver injury and small clinical studies in humans, ADVOS significantly enhanced the elimination of water\u2010soluble and protein\u2010bound toxins and metabolites, including creatinine, ammonia, blood urea nitrogen, and lactate. Cardiovascular parameters (mean arterial pressure, cerebral perfusion pressure, and cardiac index) and renal function were improved. ADVOS clears carbon dioxide (CO\n                      <jats:sub>2<\/jats:sub>\n                      ) effectively with rapid correction of pH abnormalities, achieving normalization of CO\n                      <jats:sub>2<\/jats:sub>\n                      , and bicarbonate levels. In patients with COVID\u201019 infection, ADVOS enables rapid correction of acid\u2013base disturbance and respiratory acidosis. ADVOS therapy reduces mortality in multi\u2010organ failure and has been shown to be safe with minimal adverse events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      From the small observational studies analyzed, ADVOS demonstrates excellent detoxification of water\u2010soluble and protein\u2010bound substances. In particular, ADVOS permits the correction of metabolic and respiratory acidosis through the fluid\u2010based direct removal of acid and CO\n                      <jats:sub>2<\/jats:sub>\n                      . ADVOS is associated with significant improvements in hemodynamic and biochemical parameters, a trend toward improved survival in multi\u2010organ failure, and is well\u2010tolerated. Larger randomized trials are now necessary to further validate these encouraging results.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aor.14188","type":"journal-article","created":{"date-parts":[[2022,2,6]],"date-time":"2022-02-06T23:04:26Z","timestamp":1644188666000},"page":"735-746","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["The role of the ADVanced Organ Support (ADVOS) system in critically ill patients with multiple organ failure"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1744-7717","authenticated-orcid":false,"given":"Metesh","family":"Acharya","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery Glenfield Hospital  Leicester 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