Sinusoidal obstruction syndrome medical therapy

Sinusoidal obstruction syndrome Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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Medical Therapy

• The management of sinusoidal obstruction syndrome depends on the severity of the disease.
• Supportive care is the mainstay of treatment.
• Supportive measures include:
  • Maintaining intravascular volume
  • Avoidance of hepatotoxic agents
  • Paracentesis can be done to remove ascitic fluid
  • Narcotics can be used to keep patient pain free.
• Patients with mild to moderate sinusoidal obstruction syndrome can be treated with supportive care alone. However, severe cases need defibrotide (thrombolytic agent) along with supportive care.{| class="wikitable"

! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" + |Parameters ! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" + |Mild ! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" + |Moderate ! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" + |Severe |- | align="center" style="background:#DCDCDC;" + |Serum total bilirubin |

• <5 mg/dL

|

• < (5.1 to 8 mg/dL

|

• >8 mg/dL

|- | align="center" style="background:#DCDCDC;" + |Serum aspartate aminotransferase (AST) |

• <3 x normal

|

• 3 to 8 x normal

|

• >8 x normal

|- | colspan="1" rowspan="1" align="center" style="background:#DCDCDC;" + |Weight above baseline | colspan="1" rowspan="1" |

• <2 percent

| colspan="1" rowspan="1" |

• 2 to 5 percent

|

• >5 percent

|- | colspan="1" rowspan="1" align="center" style="background:#DCDCDC;" + |Serum creatinine | colspan="1" rowspan="1" |

• Normal

| colspan="1" rowspan="1" |

• <2 x normal

|

• >2 x normal

|}