Fibroblast growth factor 21 is an early predictor of acute-on-chronic liver failure in critically ill patients with cirrhosis

2018 ◽  
Vol 24 (5) ◽  
pp. 595-605 ◽  
Author(s):  
Astrid Ruiz-Margáin ◽  
Alessandra Pohlmann ◽  
Patrick Ryan ◽  
Robert Schierwagen ◽  
Luis A. Chi-Cervera ◽  
...  
Keyword(s):  
Growth Factor ◽  
Liver Failure ◽  
Fibroblast Growth Factor ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Chronic Liver ◽  
Fibroblast Growth Factor 21 ◽  
Fibroblast Growth ◽  
Chronic Liver Failure ◽  
Early Predictor

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
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