scholarly journals Severe Alcohol‐Associated Hepatitis Is Associated With Worse Survival in Critically Ill Patients With Acute on Chronic Liver Failure

2021 ◽  
Author(s):  
Kavish R. Patidar ◽  
Jennifer L. Peng ◽  
Harleen Kaur ◽  
Astin Worden ◽  
Carla D. Kettler ◽  
...  
Keyword(s):  
Liver Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Chronic Liver ◽  
Chronic Liver Failure

Point-of-Care Echocardiography and Hemodynamic Monitoring in Cirrhosis and Acute-on-Chronic Liver Failure in the COVID-19 Era

2021 ◽  
pp. 088506662098828
Author(s):  
Madhumita Premkumar ◽  
Kamal Kajal ◽  
Anand V. Kulkarni ◽  
Ankur Gupta ◽  
Smita Divyaveer
Keyword(s):  
Intensive Care ◽  
Liver Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Point Of Care ◽  
Kidney Injury ◽  
Regional Wall Motion ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Evidenced Based

Point-of-Care (POC) transthoracic echocardiography (TTE) is transforming the management of patients with cirrhosis presenting with septic shock, acute kidney injury, hepatorenal syndrome and acute-on-chronic liver failure (ACLF) by correctly assessing the hemodynamic and volume status at the bedside using combined echocardiography and POC ultrasound (POCUS). When POC TTE is performed by the hepatologist or intensivist in the intensive care unit (ICU), and interpreted remotely by a cardiologist, it can rule out cardiovascular conditions that may be contributing to undifferentiated shock, such as diastolic dysfunction, myocardial infarction, myocarditis, regional wall motion abnormalities and pulmonary embolism. The COVID-19 pandemic has led to a delay in seeking medical treatment, reduced invasive interventions and deferment in referrals leading to “collateral damage” in critically ill patients with liver disease. Thus, the use of telemedicine in the ICU (Tele-ICU) has integrated cardiology, intensive care, and hepatology practices across the spectrum of ICU, operating room, and transplant healthcare. Telecardiology tools have improved bedside diagnosis when introduced as part of COVID-19 care by remote supervision and interpretation of POCUS and echocardiographic data. In this review, we present the contemporary approach of using POC echocardiography and offer a practical guide for primary care hepatologists and gastroenterologists for cardiac assessment in critically ill patients with cirrhosis and ACLF. Evidenced based use of Tele-ICU can prevent delay in cardiac diagnosis, optimize safe use of expert resources and ensure timely care in the setting of critically ill cirrhosis, ACLF and liver transplantation in the COVID-19 era.

The ten tips to manage critically ill patients with acute-on-chronic liver failure

2018 ◽  
Vol 44 (11) ◽  
pp. 1932-1935 ◽  
Author(s):  
Valentin Fuhrmann ◽  
Tony Whitehouse ◽  
Julia Wendon
Keyword(s):  
Liver Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Chronic Liver ◽  
Chronic Liver Failure

Balanced haemostasis with both hypo- and hyper-coagulable features in critically ill patients with acute-on-chronic-liver failure

2018 ◽  
Vol 43 ◽  
pp. 54-60 ◽  
Author(s):  
Caleb Fisher ◽  
Vishal C. Patel ◽  
Sidsel Hyldgaard Stoy ◽  
Arjuna Singanayagam ◽  
Jelle Adelmeijer ◽  
...  
Keyword(s):  
Liver Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Chronic Liver ◽  
Chronic Liver Failure

scholarly journals Prognostic value of serum lactate kinetics in critically ill patients with cirrhosis and acute-on-chronic liver failure: a multicenter study

Aging ◽  
2019 ◽  
Vol 11 (13) ◽  
pp. 4446-4462
Author(s):  
Feng Gao ◽  
Xie-lin Huang ◽  
Meng-Xing Cai ◽  
Miao-tong Lin ◽  
Bin-feng Wang ◽  
...  
Keyword(s):  
Liver Failure ◽  
Critically Ill ◽  
Multicenter Study ◽  
Critically Ill Patients ◽  
Prognostic Value ◽  
Serum Lactate ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Lactate Kinetics

Critical Care Management of Gastrointestinal Bleeding and Ascites in Liver Failure

2018 ◽  
Vol 39 (05) ◽  
pp. 566-577
Author(s):  
Kapil Rajwani ◽  
Brett Fortune ◽  
Robert Brown
Keyword(s):  
Liver Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Chronic Liver ◽  
Decompensated Cirrhosis ◽  
Endoscopic Management ◽  
Gi Bleeding ◽  
Chronic Liver Failure ◽  
Vasoactive Agent ◽  
Improve Patient Survival

AbstractGastrointestinal (GI) bleeding and ascites are two significant clinical events that frequently present in critically ill patients with chronic liver failure or decompensated cirrhosis. GI bleeding in patients with cirrhosis, particularly portal hypertensive-associated bleeding, carries a high short-term mortality (15–25%) and requires early initiation of a vasoactive agent and antibiotics as well as timely endoscopic management. Conservative transfusion strategies and adequate airway protection are also imperative to assist in bleeding control. The presence of ascites among hospitalized cirrhotics requires early analysis of ascitic fluid to diagnose spontaneous bacterial peritonitis and initiate appropriate antibiotics and albumin to reduce patients' high associated mortality rates of greater than 25%. Appropriate utilization of portal decompression using transjugular intrahepatic portosystemic shunt placement for selected patients with failure to control bleeding or ascites and early consideration for liver transplantation referral is critical to improve patient survival. This review will aim to elucidate the current strategies for the management of critically ill patients with chronic liver failure presenting with GI bleeding or ascites.

THU-045-Natural history of sepsis, organ failure and organ dysfunction in critically ill patients with acute on chronic liver failure

2019 ◽  
Vol 70 (1) ◽  
pp. e179-e180
Author(s):  
Manjul Mishra ◽  
Shiv Kumar Sarin ◽  
Vijayraghavan Rajan ◽  
Ashok Choudhury ◽  
Guresh Kumar ◽  
...  
Keyword(s):  
Natural History ◽  
Liver Failure ◽  
Organ Failure ◽  
Critically Ill ◽  
Organ Dysfunction ◽  
Critically Ill Patients ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
History Of

scholarly journals A MORTALITY PREDICTION MODEL FOR CRITICALLY ILL PATIENTS WITH ACUTE ON CHRONIC LIVER FAILURE

2015 ◽  
Vol 3 (Suppl 1) ◽  
pp. A973
Author(s):  
M Dalorzo ◽  
P Garcia Olivares ◽  
E Keough Delgado ◽  
C Bocanegra Abarca ◽  
I De Sousa ◽  
...  
Keyword(s):  
Liver Failure ◽  
Prediction Model ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Mortality Prediction ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Mortality Prediction Model
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