Intensive care management of acute-on-chronic liver failure.
Acute decompensation
Acute on chronic liver failure
Cirrhosis
Intensive care management
Liver transplantation
Organ failures
Journal
Intensive care medicine
ISSN: 1432-1238
Titre abrégé: Intensive Care Med
Pays: United States
ID NLM: 7704851
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
received:
03
04
2023
accepted:
21
06
2023
medline:
15
8
2023
pubmed:
8
8
2023
entrez:
8
8
2023
Statut:
ppublish
Résumé
Acute-on-chronic liver failure (ACLF) is a clinical syndrome defined by an acute deterioration of the liver function associated with extrahepatic organ failures requiring intensive care support and associated with a high short-term mortality. ACLF has emerged as a major cause of mortality in patients with cirrhosis and chronic liver disease. ACLF has a unique pathophysiology in which systemic inflammation plays a key role; this provides the basis of novel therapies, several of which are now in clinical trials. Intensive care unit (ICU) therapy parallels that applied in the general ICU population in some organ failures but has peculiar differential characteristics in others. Critical care management strategies and the option of liver transplantation (LT) should be balanced with futility considerations in those with a poor prognosis. Nowadays, LT is the only life-saving treatment that can radically improve the long-term prognosis of patients with ACLF. This narrative review will provide insights on the current understanding of ACLF with emphasis on intensive care management.
Identifiants
pubmed: 37552333
doi: 10.1007/s00134-023-07149-x
pii: 10.1007/s00134-023-07149-x
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
903-921Informations de copyright
© 2023. Springer-Verlag GmbH Germany, part of Springer Nature.
Références
D’Amico G, Morabito A, D’Amico M, Pasta L, Malizia G, Rebora P et al (2018) Clinical states of cirrhosis and competing risks. J Hepatol 68(3):563–576. https://doi.org/10.1016/j.jhep.2017.10.020
doi: 10.1016/j.jhep.2017.10.020
pubmed: 29111320
Arroyo V, Moreau R, Kamath PS, Jalan R, Ginès P, Nevens F et al (2016) Acute-on-chronic liver failure in cirrhosis. Nat Rev Dis Primers 2:16041. https://doi.org/10.1038/nrdp.2016.41
doi: 10.1038/nrdp.2016.41
pubmed: 27277335
Zaccherini G, Weiss E, Moreau R (2020) Acute-on-chronic liver failure: definitions, pathophysiology and principles of treatment. JHEP Rep 3(1):100176. https://doi.org/10.1016/j.jhepr.2020.100176
doi: 10.1016/j.jhepr.2020.100176
pubmed: 33205036
pmcid: 7652714
Sarin SK, Kumar A, Almeida JA, Chawla YK, Fan ST, Garg H et al (2009) Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the study of the liver (APASL). Hepatol Int 3(1):269–282. https://doi.org/10.1007/s12072-008-9106-x
doi: 10.1007/s12072-008-9106-x
pubmed: 19669378
Sarin SK, Kedarisetty CK, Abbas Z, Amarapurkar D, Bihari C, Chan AC et al (2014) Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL) 2014. Hepatol Int 8(4):453–471. https://doi.org/10.1007/s12072-014-9580-2
doi: 10.1007/s12072-014-9580-2
pubmed: 26202751
Sarin SK, Choudhury A, Sharma MK, Maiwall R, Al Mahtab M, Rahman S, APASL ACLF Research Consortium (AARC) for APASL ACLF working Party et al (2019) Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update. Hepatol Int 3(4):353–390. https://doi.org/10.1007/s12072-019-09946-3
doi: 10.1007/s12072-019-09946-3
Bajaj JS, O’Leary JG, Reddy KR, Wong F, Biggins SW, Patton H et al (2014) Survival in infection-related acute-on-chronic liver failure is defined by extrahepatic organ failures. Hepatology 60(1):250–256. https://doi.org/10.1002/hep.27077
doi: 10.1002/hep.27077
pubmed: 24677131
O’Leary JG, Reddy KR, Garcia-Tsao G, Biggins SW, Wong F, Fallon MB et al (2018) NACSELD acute-on-chronic liver failure (NACSELD-ACLF) score predicts 30-day survival in hospitalized patients with cirrhosis. Hepatology 67(6):2367–2374. https://doi.org/10.1002/hep.29773
doi: 10.1002/hep.29773
pubmed: 29315693
Bajaj JS, O’Leary JG, Lai JC, Wong F, Long MD, Wong RJ et al (2022) Acute-on-chronic liver failure clinical guidelines. Am J Gastroenterol 117(2):225–252. https://doi.org/10.14309/ajg.0000000000001595
doi: 10.14309/ajg.0000000000001595
pubmed: 35006099
Bajaj JS, Moreau R, Kamath PS, Vargas HE, Arroyo V, Reddy KR et al (2018) Acute-on-chronic liver failure: getting ready for prime time? Hepatology 68(4):1621–1632. https://doi.org/10.1002/hep.30056
doi: 10.1002/hep.30056
pubmed: 29689120
Moreau R, Jalan R, Gines P, Pavesi M, Angeli P, Cordoba J et al (2013) Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology 144(7):1426–1437, 1437.e1–9. https://doi.org/10.1053/j.gastro.2013.02.042
Arroyo V, Moreau R, Jalan R (2020) Acute-on-chronic liver failure. N Engl J Med 382(22):2137–2145. https://doi.org/10.1056/NEJMra1914900
doi: 10.1056/NEJMra1914900
pubmed: 32459924
Jalan R, Saliba F, Pavesi M, Amoros A, Moreau R, Ginès P et al (2014) Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure. J Hepatol 61(5):1038–1047. https://doi.org/10.1016/j.jhep.2014.06.012
doi: 10.1016/j.jhep.2014.06.012
pubmed: 24950482
Trebicka J, Fernandez J, Papp M, Caraceni P, Laleman W, Gambino C, PREDICT STUDY group of the EASL-CLIF Consortium et al (2020) The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology. J Hepatol 73(4):842–854. https://doi.org/10.1016/j.jhep.2020.06.013
doi: 10.1016/j.jhep.2020.06.013
pubmed: 32673741
Jalan R, D’Amico G, Trebicka J, Moreau R, Angeli P, Arroyo V (2021) New clinical and pathophysiological perspectives defining the trajectory of cirrhosis. J Hepatol 75(Suppl 1):S14–S26. https://doi.org/10.1016/j.jhep.2021.01.018
doi: 10.1016/j.jhep.2021.01.018
pubmed: 34039485
Gustot T, Fernandez J, Garcia E, Morando F, Caraceni P, Alessandria C et al (2015) Clinical Course of acute-on-chronic liver failure syndrome and effects on prognosis. Hepatology 62(1):243–252. https://doi.org/10.1002/hep.27849
doi: 10.1002/hep.27849
pubmed: 25877702
Jalan R, Pavesi M, Saliba F, Amorós A, Fernandez J, Holland-Fischer P et al (2015) The CLIF Consortium Acute Decompensation score (CLIF-C ADs) for prognosis of hospitalised cirrhotic patients without acute-on-chronic liver failure. J Hepatol 62(4):831–840. https://doi.org/10.1016/j.jhep.2014.11.012
doi: 10.1016/j.jhep.2014.11.012
pubmed: 25463539
Choudhury A, Jindal A, Maiwall R, Sharma MK, Sharma BC, Pamecha V et al (2017) Liver failure determines the outcome in patients of acute-on-chronic liver failure (ACLF): comparison of APASL ACLF research consortium (AARC) and CLIF-SOFA models. Hepatol Int 11(5):461–471. https://doi.org/10.1007/s12072-017-9816-z
doi: 10.1007/s12072-017-9816-z
pubmed: 28856540
Cao Z, Liu Y, Cai M, Xu Y, Xiang X, Zhao G et al (2020) The use of NACSELD and EASL-CLIF classification systems of ACLF in the prediction of prognosis in hospitalized patients with cirrhosis. Am J Gastroenterol 115(12):2026–2035. https://doi.org/10.14309/ajg.0000000000000771
doi: 10.14309/ajg.0000000000000771
pubmed: 32858565
Wu T, Li J, Shao L, Xin J, Jiang L, Zhou Q, Chinese Group on the Study of Severe Hepatitis B (COSSH) et al (2018) Development of diagnostic criteria and a prognostic score for hepatitis B virus-related acute-on-chronic liver failure. Gut 67(12):2181–2191. https://doi.org/10.1136/gutjnl-2017-314641
doi: 10.1136/gutjnl-2017-314641
pubmed: 28928275
Albillos A, Lario M, Álvarez-Mon M (2014) Cirrhosis-associated immune dysfunction: distinctive features and clinical relevance. J Hepatol 61(6):1385–1396. https://doi.org/10.1016/j.jhep.2014.08.010
doi: 10.1016/j.jhep.2014.08.010
pubmed: 25135860
Albillos A, Martin-Mateos R, Van der Merwe S, Wiest R, Jalan R, Álvarez-Mon M (2022) Cirrhosis-associated immune dysfunction. Nat Rev Gastroenterol Hepatol 19(2):112–134. https://doi.org/10.1038/s41575-021-00520-7
doi: 10.1038/s41575-021-00520-7
pubmed: 34703031
Martin-Mateos R, Alvarez-Mon M, Albillos A (2019) Dysfunctional immune response in acute-on-chronic liver failure: it takes two to tango. Front Immunol 10:973. https://doi.org/10.3389/fimmu.2019.00973
doi: 10.3389/fimmu.2019.00973
pubmed: 31118937
pmcid: 6504833
Wasmuth HE, Kunz D, Yagmur E, Timmer-Stranghöner A, Vidacek D, Siewert E et al (2005) Patients with acute on chronic liver failure display “sepsis-like” immune paralysis. J Hepatol 42(2):195–201. https://doi.org/10.1016/j.jhep.2004.10.019
doi: 10.1016/j.jhep.2004.10.019
pubmed: 15664244
Arroyo V, Angeli P, Moreau R, Jalan R, Clària J, Trebicka J, Investigators from the EASL-CLIF Consortium, Grifols Chair and European Foundation for the Study of Chronic Liver Failure (EF-Clif) et al (2021) The systemic inflammation hypothesis: towards a new paradigm of acute decompensation and multiorgan failure in cirrhosis. J Hepatol 74(3):670–685. https://doi.org/10.1016/j.jhep.2020.11.048
doi: 10.1016/j.jhep.2020.11.048
pubmed: 33301825
Iwasaki A, Medzhitov R (2015) Control of adaptive immunity by the innate immune system. Nat Immunol 16(4):343–353. https://doi.org/10.1038/ni.3123
doi: 10.1038/ni.3123
pubmed: 25789684
pmcid: 4507498
Ayres JS (2020) Immunometabolism of infections. Nat Rev Immunol 20(2):79–80. https://doi.org/10.1038/s41577-019-0266-9
doi: 10.1038/s41577-019-0266-9
pubmed: 31892735
Albillos A, de Gottardi A, Rescigno M (2020) The gut-liver axis in liver disease: pathophysiological basis for therapy. J Hepatol 72(3):558–577. https://doi.org/10.1016/j.jhep.2019.10.003
doi: 10.1016/j.jhep.2019.10.003
pubmed: 31622696
Bernardi M, Moreau R, Angeli P, Schnabl B, Arroyo V (2015) Mechanisms of decompensation and organ failure in cirrhosis: from peripheral arterial vasodilation to systemic inflammation hypothesis J. Hepatol 63(5):1272–1284. https://doi.org/10.1016/j.jhep.2015.07.004
doi: 10.1016/j.jhep.2015.07.004
Wong F, Piano S, Singh V, Bartoletti M, Maiwall R, Alessandria C, International Club of Ascites Global Study Group et al (2021) Clinical features and evolution of bacterial infection-related acute-on-chronic liver failure. J Hepatol 74(2):330–339. https://doi.org/10.1016/j.jhep.2020.07.046
doi: 10.1016/j.jhep.2020.07.046
pubmed: 32781201
Fernández J, Acevedo J, Wiest R, Gustot T, Amoros A, Deulofeu C, European Foundation for the Study of Chronic Liver Failure et al (2018) Bacterial and fungal infections in acute-on-chronic liver failure: prevalence, characteristics and impact on prognosis. Gut 67(10):1870–1880. https://doi.org/10.1136/gutjnl-2017-314240
doi: 10.1136/gutjnl-2017-314240
pubmed: 28847867
Fernández J, Prado V, Trebicka J, Amoros A, Gustot T, Wiest R, European Foundation for the Study of Chronic Liver Failure (EF-Clif) et al (2019) Multidrug-resistant bacterial infections in patients with decompensated cirrhosis and with acute-on-chronic liver failure in Europe. J Hepatol 70(3):398–411. https://doi.org/10.1016/j.jhep.2018.10.027
doi: 10.1016/j.jhep.2018.10.027
pubmed: 30391380
Fernández J, Piano S, Bartoletti M, Wey EQ (2021) Management of bacterial and fungal infections in cirrhosis: the MDRO challenge. J Hepatol 75(Suppl 1):S101–S117. https://doi.org/10.1016/j.jhep.2020.11.010
doi: 10.1016/j.jhep.2020.11.010
pubmed: 34039482
Prado V, Hernández-Tejero M, Mücke MM, Marco F, Gu W, Amoros A et al (2022) Rectal colonization by resistant bacteria increases the risk of infection by the colonizing strain in critically ill patients with cirrhosis. J Hepatol 76(5):1079–1089. https://doi.org/10.1016/j.jhep.2021.12.042
doi: 10.1016/j.jhep.2021.12.042
pubmed: 35074475
Bajaj JS, Reddy RK, Tandon P, Wong F, Kamath PS, Biggins SW et al (2018) Prediction of fungal infection development and their impact on survival using the NACSELD cohort. Am J Gastroenterol 113(4):556–563. https://doi.org/10.1038/ajg.2017.471
doi: 10.1038/ajg.2017.471
pubmed: 29257141
Tergast TL, Beier C, Maasoumy B (2019) Mistakes in decompensated liver cirrhosis and how to avoid them. UEG Education, vol 19
Garcia-Compean D, Jaquez-Quintana JO, Gonzalez-Gonzalez JA, Maldonado-Garza H (2009) Liver cirrhosis and diabetes: risk factors, pathophysiology, clinical implications and management. World J Gastroenterol 15(3):280–288. https://doi.org/10.3748/wjg.15.280
doi: 10.3748/wjg.15.280
pubmed: 19140227
pmcid: 2653324
Yamada T, Shojima N, Noma H, Yamauchi T, Kadowaki T (2017) Glycemic control, mortality, and hypoglycemia in critically ill patients: a systematic review and network meta-analysis of randomized controlled trials. Intensive Care Med 43(1):1–15. https://doi.org/10.1007/s00134-016-4523-0
doi: 10.1007/s00134-016-4523-0
pubmed: 27637719
Sam J, Nguyen GC (2009) Protein-calorie malnutrition as a prognostic indicator of mortality among patients hospitalized with cirrhosis and portal hypertension. Liver Int 29(9):1396–1402. https://doi.org/10.1111/j.1478-3231.2009.02077.x
doi: 10.1111/j.1478-3231.2009.02077.x
pubmed: 19602136
European Association for the Study of the Liver (2019) EASL Clinical Practice Guidelines on nutrition in chronic liver disease. J Hepatol 70(1):172–193. https://doi.org/10.1016/j.jhep.2018.06.024
doi: 10.1016/j.jhep.2018.06.024
Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP et al (2019) ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr 38(1):48–79. https://doi.org/10.1016/j.clnu.2018.08.037
doi: 10.1016/j.clnu.2018.08.037
pubmed: 30348463
Reintam Blaser A, Starkopf J, Alhazzani W, Berger MM, Casaer MP, Deane AM, ESICM Working Group on Gastrointestinal Function et al (2017) Early enteral nutrition in critically ill patients: ESICM clinical practice guidelines. Intensive Care Med 43(3):380–398. https://doi.org/10.1007/s00134-016-4665-0
doi: 10.1007/s00134-016-4665-0
pubmed: 28168570
pmcid: 5323492
Al-Obaid LN, Bazarbashi AN, Cohen ME, Kim J, Lei Y, Axelrad JE et al (2019) Enteric tube placement in patients with esophageal varices: risks and predictors of postinsertion gastrointestinal bleeding. JGH Open 4(2):256–259. https://doi.org/10.1002/jgh3.12255.eCollection
doi: 10.1002/jgh3.12255.eCollection
pubmed: 32280774
pmcid: 7144797
Hébuterne X, Vanbiervliet G (2011) Feeding the patients with upper gastrointestinal bleeding. Curr Opin Clin Nutr Metab Care 14(2):197–201. https://doi.org/10.1097/MCO.0b013e3283436dc5
doi: 10.1097/MCO.0b013e3283436dc5
pubmed: 21252654
Casaer MP, Mesotten D, Hermans G, Wouters PJ, Schetz M, Meyfroidt G, Van Cromphaut S, Ingels C et al (2011) Early versus late parenteral nutrition in critically ill adults. N Engl J Med 365(6):506–517. https://doi.org/10.1056/NEJMoa1102662
doi: 10.1056/NEJMoa1102662
pubmed: 21714640
Gluud LL, Dam G, Les I, Córdoba J, Marchesini G, Borre M et al (2015) Branched-chain amino acids for people with hepatic encephalopathy. Cochrane Database Syst Rev 9:CD001939. https://doi.org/10.1002/14651858.CD001939.pub3
doi: 10.1002/14651858.CD001939.pub3
Plauth M, Bernal W, Dasarathy S, Merli M, Plank LD, Schütz T et al (2019) ESPEN guideline on clinical nutrition in liver disease. Clin Nutr 38(2):485–521. https://doi.org/10.1016/j.clnu.2018.12.022
doi: 10.1016/j.clnu.2018.12.022
pubmed: 30712783
pmcid: 6686849
Tripodi A, Mannucci PM (2011) The coagulopathy of chronic liver disease. N Engl J Med 365(2):147–156. https://doi.org/10.1056/NEJMra1011170
doi: 10.1056/NEJMra1011170
pubmed: 21751907
Lisman T, Caldwell SH, Intagliata NM (2022) Haemostatic alterations and management of haemostasis in patients with cirrhosis. J Hepatol 76(6):1291–1305. https://doi.org/10.1016/j.jhep.2021.11.004
doi: 10.1016/j.jhep.2021.11.004
pubmed: 35589251
Saner FH, Bezinover D (2019) Assessment and management of coagulopathy in critically-ill patients with liver failure. Curr Opin Crit Care 25(2):179–186. https://doi.org/10.1097/MCC.0000000000000591
doi: 10.1097/MCC.0000000000000591
pubmed: 30855324
Zanetto A, Northup P, Roberts L, Senzolo M (2023) Haemostasis in cirrhosis: understanding destabilising factors during acute decompensation. J Hepatol 78(5):1037–1047. https://doi.org/10.1016/j.jhep.2023.01.010
doi: 10.1016/j.jhep.2023.01.010
pubmed: 36708812
Fisher C, Patel VC, Stoy SH, Singanayagam A, Adelmeijer J, Wendon J et al (2018) Balanced haemostasis with both hypo- and hyper-coagulable features in critically ill patients with acute-on-chronic-liver failure. J Crit Care 43:54–60. https://doi.org/10.1016/j.jcrc.2017.07.053
doi: 10.1016/j.jcrc.2017.07.053
pubmed: 28843665
Blasi A, Patel VC, Adelmeijer J, Azarian S, Hernandez Tejero M, Calvo A et al (2020) Mixed fibrinolytic phenotypes in decompensated cirrhosis and acute-on-chronic liver failure with hypofibrinolysis in those with complications and poor survival. Hepatology 71(4):1381–1390. https://doi.org/10.1002/hep.30915
doi: 10.1002/hep.30915
pubmed: 31465557
de Franchis R, Bosch J, Garcia-Tsao G, Reiberger T, Ripoll C, Baveno VII Faculty (2022) Renewing consensus in portal hypertension. J Hepatol 76(4):959–974. https://doi.org/10.1016/j.jhep.2021.12.022
doi: 10.1016/j.jhep.2021.12.022
pubmed: 35120736
European Association for the Study of the Liver (2022) EASL Clinical Practice Guidelines on prevention and management of bleeding and thrombosis in patients with cirrhosis. J Hepatol 76(5):1151–1184. https://doi.org/10.1016/j.jhep.2021.09.003
doi: 10.1016/j.jhep.2021.09.003
De Pietri L, Bianchini M, Montalti R, De Maria N, Di Maira T, Begliomini B et al (2016) Thrombelastography-guided blood product use before invasive procedures in cirrhosis with severe coagulopathy: a randomized, controlled trial. Hepatology 63(2):566–573. https://doi.org/10.1002/hep.28148
doi: 10.1002/hep.28148
pubmed: 26340411
Kumar M, Ahmad J, Maiwall R, Choudhury A, Bajpai M, Mitra LG et al (2020) Thromboelastography-guided blood component use in patients with cirrhosis with nonvariceal bleeding: a randomized controlled trial. Hepatology 71(1):235–246. https://doi.org/10.1002/hep.30794
doi: 10.1002/hep.30794
pubmed: 31148204
Vuyyuru SK, Singh AD, Gamanagatti SR, Rout G, Gunjan D, Shalimar (2020) A randomized control trial of thromboelastography-guided transfusion in cirrhosis for high-risk invasive liver-related procedures. Dig Dis Sci 65(7):2104–2111. https://doi.org/10.1007/s10620-019-05939-2
doi: 10.1007/s10620-019-05939-2
pubmed: 31720889
Roberts LN, Bernal W (2020) Incidence of bleeding and thrombosis in patients with liver disease. Semin Thromb Hemost 46(6):656–664. https://doi.org/10.1055/s-0040-1714205
doi: 10.1055/s-0040-1714205
pubmed: 32757184
Rassi AB, d’Amico EA, Tripodi A, da Rocha TRF, Migita BY, Ferreira CM et al (2020) Fresh frozen plasma transfusion in patients with cirrhosis and coagulopathy: effect on conventional coagulation tests and thrombomodulin-modified thrombin generation. J Hepatol 72(1):85–94. https://doi.org/10.1016/j.jhep.2019.09.008
doi: 10.1016/j.jhep.2019.09.008
pubmed: 31536747
van Dievoet MA, Stephenne X, Rousseaux M, Lisman T, Hermans C, Deneys V (2023) The use of prothrombin complex concentrate in chronic liver disease: a review of the literature. Transfus Med. https://doi.org/10.1111/tme.12969
doi: 10.1111/tme.12969
pubmed: 36941801
Lisman T, Arefaine B, Adelmeijer J, Zamalloa A, Corcoran E, Smith JG et al (2021) Global hemostatic status in patients with acute-on-chronic liver failure and septics without underlying liver disease. J Thromb Haemost 19(1):85–95. https://doi.org/10.1111/jth.15112
doi: 10.1111/jth.15112
pubmed: 33006808
Caldwell SH, Hoffman M, Lisman T, Macik BG, Northup PG, Coagulation in Liver Disease Group et al (2006) Coagulation disorders and hemostasis in liver disease: pathophysiology and critical assessment of current management. Hepatology 44(4):1039–1046. https://doi.org/10.1002/hep.21303
doi: 10.1002/hep.21303
pubmed: 17006940
Villanueva C, Colomo A, Bosch A, Concepción M, Hernandez-Gea V, Aracil C et al (2013) Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med 368(1):11–21. https://doi.org/10.1056/NEJMoa1211801
doi: 10.1056/NEJMoa1211801
pubmed: 23281973
Flamm SL, Wong F, Ahn J, Kamath PS (2022) AGA clinical practice update on the evaluation and management of acute kidney injury in patients with cirrhosis: expert review. Clin Gastroenterol Hepatol 20(12):2707–2716. https://doi.org/10.1016/j.cgh.2022.08.033
doi: 10.1016/j.cgh.2022.08.033
pubmed: 36075500
Nadim MK, Garcia-Tsao G (2023) Acute kidney injury in patients with cirrhosis. N Engl J Med 388(8):733–745. https://doi.org/10.1056/NEJMra2215289
doi: 10.1056/NEJMra2215289
pubmed: 36812435
Angeli P, Ginès P, Wong F, Bernardi M, Boyer TD, Gerbes A et al (2015) Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites. J Hepatol 62(4):968–974. https://doi.org/10.1016/j.jhep.2014.12.029
doi: 10.1016/j.jhep.2014.12.029
pubmed: 25638527
Angeli P, Garcia-Tsao G, Nadim MK, Parikh CR (2019) News in pathophysiology, definition and classification of hepatorenal syndrome: a step beyond the International Club of Ascites (ICA) consensus document. J Hepatol 71(4):811–822. https://doi.org/10.1016/j.jhep.2019.07.002
doi: 10.1016/j.jhep.2019.07.002
pubmed: 31302175
Amathieu R, Al-Khafaji A, Sileanu FE, Foldes E, DeSensi R, Hilmi I et al (2017) Significance of oliguria in critically ill patients with chronic liver disease. Hepatology 66(5):1592–1600. https://doi.org/10.1002/hep.29303
doi: 10.1002/hep.29303
pubmed: 28586126
Singal AK, Jalan R (2023) Terlipressin for hepatorenal syndrome: opportunities and challenges. Lancet Gastroenterol Hepatol 8(2):104–106. https://doi.org/10.1016/S2468-1253(22)00377-6
doi: 10.1016/S2468-1253(22)00377-6
pubmed: 36620975
Wong F, Pappas SC, Curry MP, Reddy KR, Rubin RA, Porayko MK, CONFIRM Study Investigators et al (2021) Terlipressin plus albumin for the treatment of type 1 hepatorenal syndrome. N Engl J Med 384(9):818–828. https://doi.org/10.1056/NEJMoa2008290
doi: 10.1056/NEJMoa2008290
pubmed: 33657294
Arora V, Maiwall R, Rajan V, Jindal A, Muralikrishna Shasthry S et al (2020) Terlipressin is superior to noradrenaline in the management of acute kidney injury in acute on chronic liver failure. Hepatology 71(2):600–610. https://doi.org/10.1002/hep.30208
doi: 10.1002/hep.30208
pubmed: 30076614
Facciorusso A, Chandar AK, Murad MH, Prokop LJ, Muscatiello N, Kamath PS et al (2017) Comparative efficacy of pharmacological strategies for management of type 1 hepatorenal syndrome: a systematic review and network meta-analysis. Lancet Gastroenterol Hepatol 2(2):94–102. https://doi.org/10.1016/S2468-1253(16)30157-1
doi: 10.1016/S2468-1253(16)30157-1
pubmed: 28403995
Piano S, Schmidt HH, Ariza X, Amoros A, Romano A, Hüsing-Kabar A et al (2018) Association between grade of acute on chronic liver failure and response to terlipressin and albumin in patients with hepatorenal syndrome. Clin Gastroenterol Hepatol 16(11):1792-1800.e3. https://doi.org/10.1016/j.cgh.2018.01.035
doi: 10.1016/j.cgh.2018.01.035
pubmed: 29391267
European Association for the Study of the Liver (2018) EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J Hepatol 69(2):406–460. https://doi.org/10.1016/j.jhep.2018.03.024
doi: 10.1016/j.jhep.2018.03.024
Slowinski T, Morgera S, Joannidis M, Henneberg T, Stocker R, Helset E et al (2015) Safety and efficacy of regional citrate anticoagulation in continuous venovenous hemodialysis in the presence of liver failure: the Liver Citrate Anticoagulation Threshold (L-CAT) observational study. Crit Care 19:349. https://doi.org/10.1186/s13054-015-1066-7
doi: 10.1186/s13054-015-1066-7
pubmed: 26415638
pmcid: 4587580
Bernal W, Karvellas C, Saliba F, Saner FH, Meersseman P (2021) Intensive care management of acute-on-chronic liver failure. J Hepatol 75(Suppl 1):S163–S177. https://doi.org/10.1016/j.jhep.2020.10.024
doi: 10.1016/j.jhep.2020.10.024
pubmed: 34039487
Parikh NS, Navi BB, Schneider Y, Jesudian A, Kamel H (2017) Association between cirrhosis and stroke in a nationally representative cohort. JAMA Neurol 74(8):927–932. https://doi.org/10.1001/jamaneurol.2017.0923
doi: 10.1001/jamaneurol.2017.0923
pubmed: 28586894
pmcid: 5710331
Romero-Gómez M, Montagnese S, Jalan R (2015) Hepatic encephalopathy in patients with acute decompensation of cirrhosis and acute-on-chronic liver failure. J Hepatol 62(2):437–447. https://doi.org/10.1016/j.jhep.2014.09.005
doi: 10.1016/j.jhep.2014.09.005
pubmed: 25218789
Ferenci P, Lockwood A, Mullen K, Tarter R, Weissenborn K, Blei AT (2002) Hepatic encephalopathy–definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology 35(3):716–721. https://doi.org/10.1053/jhep.2002.31250
doi: 10.1053/jhep.2002.31250
pubmed: 11870389
Bajaj JS, O’Leary JG, Tandon P, Wong F, Garcia-Tsao G, Kamath PS et al (2017) Hepatic encephalopathy is associated with mortality in patients with cirrhosis independent of other extrahepatic organ failures. Clin Gastroenterol Hepatol 15(4):565-574.e4. https://doi.org/10.1016/j.cgh.2016.09.157
doi: 10.1016/j.cgh.2016.09.157
pubmed: 27720916
Jalan R, Rose CF (2022) Heretical thoughts into hepatic encephalopathy. J Hepatol 77(2):539–548. https://doi.org/10.1016/j.jhep.2022.03.014
doi: 10.1016/j.jhep.2022.03.014
pubmed: 35358618
Cordoba J, Ventura-Cots M, Simón-Talero M, Amorós À, Pavesi M, Vilstrup H, Angeli P, CANONIC Study Investigators of EASL-CLIF Consortium et al (2014) Characteristics, risk factors, and mortality of cirrhotic patients hospitalized for hepatic encephalopathy with and without acute-on-chronic liver failure (ACLF). J Hepatol 60(2):275–281. https://doi.org/10.1016/j.jhep.2013.10.004
doi: 10.1016/j.jhep.2013.10.004
pubmed: 24128414
Gluud LL, Vilstrup H, Morgan MY (2016) Non-absorbable disaccharides versus placebo/no intervention and lactulose versus lactitol for the prevention and treatment of hepatic encephalopathy in people with cirrhosis. Cochrane Database Syst Rev 5:CD003044. https://doi.org/10.1002/14651858.CD003044.pub4
doi: 10.1002/14651858.CD003044.pub4
Rahimi RS, Singal AG, Cuthbert JA, Rockey DC (2014) Lactulose vs polyethylene glycol 3350–electrolyte solution for treatment of overt hepatic encephalopathy: the HELP randomized clinical trial. JAMA Intern Med 174(11):1727–1733. https://doi.org/10.1001/jamainternmed.2014.4746
doi: 10.1001/jamainternmed.2014.4746
pubmed: 25243839
pmcid: 5609454
Bass NM, Mullen KD, Sanyal A, Poordad F, Neff G, Leevy CB et al (2010) Rifaximin treatment in hepatic encephalopathy. N Engl J Med 362(12):1071–1081. https://doi.org/10.1056/NEJMoa0907893
doi: 10.1056/NEJMoa0907893
pubmed: 20335583
Jalan R, Wright G, Davies NA, Hodges SJ (2007) L-Ornithine phenylacetate (OP): a novel treatment for hyperammonemia and hepatic encephalopathy. Med Hypotheses 69(5):1064–1069. https://doi.org/10.1016/j.mehy.2006.12.061
doi: 10.1016/j.mehy.2006.12.061
pubmed: 17467190
Ventura-Cots M, Arranz JA, Simón-Talero M, Torrens M, Blanco A, Riudor E et al (2013) Safety of ornithine phenylacetate in cirrhotic decompensated patients: an open-label, dose-escalating, single-cohort study. J Clin Gastroenterol 47(10):881–887. https://doi.org/10.1097/MCG.0b013e318299c789
doi: 10.1097/MCG.0b013e318299c789
pubmed: 23751856
Butterworth RF, McPhail MJW (2019) L-ornithine L-aspartate (LOLA) for hepatic encephalopathy in cirrhosis: results of randomized controlled trials and meta-analyses. Drugs 79(Suppl 1):31–37. https://doi.org/10.1007/s40265-018-1024-1
doi: 10.1007/s40265-018-1024-1
pubmed: 30706425
pmcid: 6416237
Goh ET, Stokes CS, Sidhu SS, Vilstrup H, Gluud LL, Morgan MY (2018) L-ornithine L-aspartate for prevention and treatment of hepatic encephalopathy in people with cirrhosis. Cochrane Database Syst Rev 5(5):CD012410. https://doi.org/10.1002/14651858.CD012410.pub2
doi: 10.1002/14651858.CD012410.pub2
pubmed: 29762873
Jain A, Sharma BC, Mahajan B, Srivastava S, Kumar A, Sachdeva S et al (2022) L-ornithine L-aspartate in acute treatment of severe hepatic encephalopathy: a double-blind randomized controlled trial. Hepatology 75(5):1194–1203. https://doi.org/10.1002/hep.32255
doi: 10.1002/hep.32255
pubmed: 34822189
Rockey DC, Vierling JM, Mantry P, Ghabril M, Brown RS Jr, Alexeeva O, HALT-HE Study Group et al (2014) Randomized, double-blind, controlled study of glycerol phenylbutyrate in hepatic encephalopathy. Hepatology 59(3):1073–1083. https://doi.org/10.1002/hep.26611
doi: 10.1002/hep.26611
pubmed: 23847109
Cardoso FS, Gottfried M, Tujios S, Olson JC, Karvellas CJ, US Acute Liver Failure Study Group (2018) Continuous renal replacement therapy is associated with reduced serum ammonia levels and mortality in acute liver failure. Hepatology 67(2):711–720. https://doi.org/10.1002/hep.29488
doi: 10.1002/hep.29488
pubmed: 28859230
Jalan R, Kapoor D (2004) Reversal of diuretic-induced hepatic encephalopathy with infusion of albumin but not colloid. Clin Sci (Lond) 106(5):467–474. https://doi.org/10.1042/CS20030357
doi: 10.1042/CS20030357
pubmed: 14678008
China L, Freemantle N, Forrest E, Kallis Y, Ryder SD, Wright G, ATTIRE Trial Investigators et al (2021) A randomized trial of albumin infusions in hospitalized patients with cirrhosis. N Engl J Med 384(9):808–817. https://doi.org/10.1056/NEJMoa2022166
doi: 10.1056/NEJMoa2022166
pubmed: 33657293
Bañares R, Nevens F, Larsen FS, Jalan R, Albillos A, Dollinger M, RELIEF Study Group et al (2013) Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute-on-chronic liver failure: the RELIEF trial. Hepatology 57(3):1153–1162. https://doi.org/10.1002/hep.26185
doi: 10.1002/hep.26185
pubmed: 23213075
Hassanein TI, Tofteng F, Brown RS Jr, McGuire B, Lynch P, Mehta R et al (2007) Randomized controlled study of extracorporeal albumin dialysis for hepatic encephalopathy in advanced cirrhosis. Hepatology 46(6):1853–1862. https://doi.org/10.1002/hep.21930
doi: 10.1002/hep.21930
pubmed: 17975845
Liebchen U, Paal M, Gräfe C, Zoller M, Scharf C, Cyto-SOLVE Study Group (2023) The cytokine adsorber Cytosorb
doi: 10.1007/s00134-023-06998-w
pubmed: 36763124
pmcid: 9998587
Levesque E, Saliba F, Ichaï P, Samuel D (2014) Outcome of patients with cirrhosis requiring mechanical ventilation in ICU. J Hepatol 60(3):570–578. https://doi.org/10.1016/j.jhep.2013.11.012
doi: 10.1016/j.jhep.2013.11.012
pubmed: 24280294
Nanchal R, Subramanian R, Karvellas CJ, Hollenberg SM, Peppard WJ, Singbartl K et al (2020) guidelines for the management of adult acute and acute-on-chronic liver failure in the ICU: cardiovascular, endocrine, hematologic, pulmonary, and renal considerations. Crit Care Med 48(3):e173–e191. https://doi.org/10.1097/CCM.0000000000004192
doi: 10.1097/CCM.0000000000004192
pubmed: 32058387
Boivin Z, Perez MF, Atuegwu NC, Anzueto A, Mortensen EM (2019) Impact of cirrhosis on pneumonia-related outcomes in hospitalized older veterans. Am J Med Sci 357(4):296–301. https://doi.org/10.1016/j.amjms.2019.01.004
doi: 10.1016/j.amjms.2019.01.004
pubmed: 30904044
pmcid: 6863737
Viasus D, Garcia-Vidal C, Castellote J, Adamuz J, Verdaguer R, Dorca J et al (2011) Community-acquired pneumonia in patients with liver cirrhosis: clinical features, outcomes, and usefulness of severity scores. Medicine (Baltimore) 90(2):110–118. https://doi.org/10.1097/MD.0b013e318210504c
doi: 10.1097/MD.0b013e318210504c
pubmed: 21358441
Fernández J, Acevedo J, Prado V, Mercado M, Castro M, Pavesi M et al (2017) Clinical course and short-term mortality of cirrhotic patients with infections other than spontaneous bacterial peritonitis. Liver Int 37(3):385–395. https://doi.org/10.1111/liv.13239
doi: 10.1111/liv.13239
pubmed: 27558198
Hung TH, Tseng CW, Hsieh YH, Tseng KC, Tsai CC, Tsai CC (2013) High mortality of pneumonia in cirrhotic patients with ascites. BMC Gastroenterol 13:25. https://doi.org/10.1186/1471-230X-13-25
doi: 10.1186/1471-230X-13-25
pubmed: 23390924
pmcid: 3599048
Weil D, Levesque E, McPhail M, Cavallazzi R, Theocharidou E, Cholongitas E, METAREACIR Group (2017) Prognosis of cirrhotic patients admitted to intensive care unit: a meta-analysis. Ann Intensive Care 7(1):33. https://doi.org/10.1186/s13613-017-0249-6
doi: 10.1186/s13613-017-0249-6
pubmed: 28321803
pmcid: 5359266
Franceschini E, Dolci G, Santoro A, Meschiari M, Riccò A, Menozzi M et al (2023) Pneumocystis jirovecii pneumonia in patients with decompensated cirrhosis: a case series. Int J Infect Dis 128:254–256. https://doi.org/10.1016/j.ijid.2022.12.027
doi: 10.1016/j.ijid.2022.12.027
pubmed: 36610658
Faria LC, Ichai P, Saliba F, Benhamida S, Antoun F, Castaing D et al (2008) Pneumocystis pneumonia: an opportunistic infection occurring in patients with severe alcoholic hepatitis. Eur J Gastroenterol Hepatol 20(1):26–28. https://doi.org/10.1097/MEG.0b013e3282f16a10
doi: 10.1097/MEG.0b013e3282f16a10
pubmed: 18090986
Rodríguez-Roisin R, Krowka MJ, Hervé P, Fallon MB, ERS Task Force Pulmonary-Hepatic Vascular Disorders (PHD) Scientific Committee (2004) Pulmonary-hepatic vascular disorders (PHD). Eur Respir J 24(5):861–880. https://doi.org/10.1183/09031936.04.00010904
doi: 10.1183/09031936.04.00010904
pubmed: 15516683
Krowka MJ, Fallon MB, Kawut SM, Fuhrmann V, Heimbach JK, Ramsay MA et al (2016) International Liver Transplant Society Practice Guidelines: diagnosis and management of hepatopulmonary syndrome and portopulmonary hypertension. Transplantation 100(7):1440–1452. https://doi.org/10.1097/TP.0000000000001229
doi: 10.1097/TP.0000000000001229
pubmed: 27326810
Simonneau G, Gatzoulis MA, Adatia I, Celermajer D, Denton C, Ghofrani A et al (2013) Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 62(25 Suppl):D34–D41. https://doi.org/10.1016/j.jacc.2013.10.029
doi: 10.1016/j.jacc.2013.10.029
pubmed: 24355639
DuBrock HM, Krowka MJ (2020) The myths and realities of portopulmonary hypertension. Hepatology 72(4):1455–1460. https://doi.org/10.1002/hep.31415
doi: 10.1002/hep.31415
pubmed: 32515501
Sitbon O, Bosch J, Cottreel E, Csonka D, de Groote P, Hoeper MM et al (2019) Macitentan for the treatment of portopulmonary hypertension (PORTICO): a multicentre, randomised, double-blind, placebo-controlled, phase 4 trial. Lancet Respir Med 7(7):594–604. https://doi.org/10.1016/S2213-2600(19)30091-8
doi: 10.1016/S2213-2600(19)30091-8
pubmed: 31178422
Thuluvath PJ, Thuluvath AJ, Hanish S, Savva Y (2018) Liver transplantation in patients with multiple organ failures: feasibility and outcomes. J Hepatol 69(5):1047–1056. https://doi.org/10.1016/j.jhep.2018.07.007
doi: 10.1016/j.jhep.2018.07.007
pubmed: 30071241
Sundaram V, Jalan R, Wu T, Volk ML, Asrani SK, Klein AS et al (2019) Factors associated with survival of patients with severe acute-on-chronic liver failure before and after liver transplantation. Gastroenterology 156(5):1381-1391.e3. https://doi.org/10.1053/j.gastro.2018.12.007
doi: 10.1053/j.gastro.2018.12.007
pubmed: 30576643
Knaak J, McVey M, Bazerbachi F, Goldaracena N, Spetzler V, Selzner N et al (2015) Liver transplantation in patients with end-stage liver disease requiring intensive care unit admission and intubation. Liver Transpl 21(6):761–767. https://doi.org/10.1002/lt.24115
doi: 10.1002/lt.24115
pubmed: 25865305
Artzner T, Michard B, Weiss E, Barbier L, Noorah Z, Merle JC et al (2020) Liver transplantation for critically ill cirrhotic patients: Stratifying utility based on pretransplant factors. Am J Transplant 20(9):2437–2448. https://doi.org/10.1111/ajt.15852
doi: 10.1111/ajt.15852
pubmed: 32185866
Casoni GL, Gurioli C, Corso R, Gurioli C, Poletti V (2010) Hemothorax by intercostal varicose veins in alcoholic liver cirrhosis. Respiration 80(1):71–72. https://doi.org/10.1159/000233446
doi: 10.1159/000233446
pubmed: 19672045
Patil M, Dhillon SS, Attwood K, Saoud M, Alraiyes AH, Harris K (2017) Management of benign pleural effusions using indwelling pleural catheters: a systematic review and meta-analysis. Chest 151(3):626–635. https://doi.org/10.1016/j.chest.2016.10.052
doi: 10.1016/j.chest.2016.10.052
pubmed: 27845052
Wong F, Liu P, Lilly L, Bomzon A, Blendis L (1999) Role of cardiac structural and functional abnormalities in the pathogenesis of hyperdynamic circulation and renal sodium retention in cirrhosis. Clin Sci (Lond) 97(3):259–267
doi: 10.1042/cs0970259
pubmed: 10464050
Wiese S, Hove JD, Bendtsen F, Møller S (2014) Cirrhotic cardiomyopathy: pathogenesis and clinical relevance. Nat Rev Gastroenterol Hepatol 11(3):177–186. https://doi.org/10.1038/nrgastro.2013.210
doi: 10.1038/nrgastro.2013.210
pubmed: 24217347
Izzy M, VanWagner LB, Lin G, Altieri M, Findlay JY, Oh JK, Cirrhotic Cardiomyopathy Consortium et al (2020) Redefining cirrhotic cardiomyopathy for the modern era. Hepatology 71(1):334–345. https://doi.org/10.1002/hep.30875
doi: 10.1002/hep.30875
pubmed: 31342529
Paugam-Burtz C, Levesque E, Louvet A, Thabut D, Amathieu R, Bureau C et al (2020) Management of liver failure in general intensive care unit. Anaesth Crit Care Pain Med 39(1):143–161. https://doi.org/10.1016/j.accpm.2019.06.014
doi: 10.1016/j.accpm.2019.06.014
pubmed: 31525507
Nadim MK, Durand F, Kellum JA, Levitsky J, O’Leary JG, Karvellas CJ et al (2016) Management of the critically ill patient with cirrhosis: a multidisciplinary perspective. J Hepatol 64(3):717–735. https://doi.org/10.1016/j.jhep.2015.10.019
doi: 10.1016/j.jhep.2015.10.019
pubmed: 26519602
Philips CA, Maiwall R, Sharma MK, Jindal A, Choudhury AK, Kumar G et al (2021) Comparison of 5% human albumin and normal saline for fluid resuscitation in sepsis induced hypotension among patients with cirrhosis (FRISC study): a randomized controlled trial. Hepatol Int 15(4):983–994. https://doi.org/10.1007/s12072-021-10164-z
doi: 10.1007/s12072-021-10164-z
pubmed: 34036519
Maiwall R, Kumar A, Pasupuleti SSR, Hidam AK, Tevethia H, Kumar G et al (2022) A randomized-controlled trial comparing 20% albumin to plasmalyte in patients with cirrhosis and sepsis-induced hypotension [ALPS trial]. J Hepatol 77(3):670–682. https://doi.org/10.1016/j.jhep.2022.03.043
doi: 10.1016/j.jhep.2022.03.043
pubmed: 35460725
Cardoso FS, Pereira R, Laranjo A, Gamelas V, Bagulho L, Germano N et al (2021) Positive fluid balance was associated with mortality in patients with acute-on-chronic liver failure: a cohort study. J Crit Care 63:238–242. https://doi.org/10.1016/j.jcrc.2020.09.012
doi: 10.1016/j.jcrc.2020.09.012
pubmed: 32988683
Myc LA, Stine JG, Chakrapani R, Kadl A, Argo CK (2017) Vasopressin use in critically ill cirrhosis patients with catecholamine-resistant septic shock: the CVICU cohort. World J Hepatol 9(2):106–113. https://doi.org/10.4254/wjh.v9.i2.106
doi: 10.4254/wjh.v9.i2.106
pubmed: 28144392
pmcid: 5241528
Tsai MH, Peng YS, Chen YC, Liu NJ, Ho YP, Fang JT et al (2006) Adrenal insufficiency in patients with cirrhosis, severe sepsis and septic shock. Hepatology 43(4):673–681. https://doi.org/10.1002/hep.21101
doi: 10.1002/hep.21101
pubmed: 16557538
Fernández J, Escorsell A, Zabalza M, Felipe V, Navasa M, Mas A et al (2006) Adrenal insufficiency in patients with cirrhosis and septic shock: effect of treatment with hydrocortisone on survival. Hepatology 44(5):1288–1295. https://doi.org/10.1002/hep.21352
doi: 10.1002/hep.21352
pubmed: 17058239
Wentworth BJ, Henry ZH, Siragy HM (2022) How i approach it: adrenal insufficiency in cirrhosis. Am J Gastroenterol 117(12):1889–1893. https://doi.org/10.14309/ajg.0000000000001939
doi: 10.14309/ajg.0000000000001939
pubmed: 35980083
Arabi YM, Aljumah A, Dabbagh O, Tamim HM, Rishu AH, Al-Abdulkareem A et al (2010) Low-dose hydrocortisone in patients with cirrhosis and septic shock: a randomized controlled trial. CMAJ 182(18):1971–1977. https://doi.org/10.1503/cmaj.090707
doi: 10.1503/cmaj.090707
pubmed: 21059778
pmcid: 3001503
Harry R, Auzinger G, Wendon J (2003) The effects of supraphysiological doses of corticosteroids in hypotensive liver failure. Liver Int 23(2):71–77. https://doi.org/10.1034/j.1600-0676.2003.00813.x
doi: 10.1034/j.1600-0676.2003.00813.x
pubmed: 12654129
Tongyoo S, Sutthipool K, Viarasilpa T, Permpikul C (2022) Serum lactate levels in cirrhosis and non-cirrhosis patients with septic shock. Acute Crit Care 37(1):108–117. https://doi.org/10.4266/acc.2021.00332
doi: 10.4266/acc.2021.00332
pubmed: 34784662
Cheng CY, Kung CT, Wu KH, Chen FC, Cheng HH, Cheng FJ et al (2021) Liver cirrhosis affects serum lactate level measurement while assessing disease severity in patients with sepsis. Eur J Gastroenterol Hepatol 33(9):1201–1208. https://doi.org/10.1097/MEG.0000000000001826
doi: 10.1097/MEG.0000000000001826
pubmed: 32576767
Sarmast N, Ogola GO, Kouznetsova M, Leise MD, Bahirwani R, Maiwall R et al (2020) Model for end-stage liver disease-lactate and prediction of inpatient mortality in patients with chronic liver disease. Hepatology 72(5):1747–1757. https://doi.org/10.1002/hep.31199
doi: 10.1002/hep.31199
pubmed: 32083761
Krispin I, Mahamid M, Goldin E, Fteiha B (2023) Elevated lactate/albumin ratio as a novel predictor of in-hospital mortality in hospitalized cirrhotics. Ann Hepatol 28(3):100897. https://doi.org/10.1016/j.aohep.2023.100897
doi: 10.1016/j.aohep.2023.100897
pubmed: 36632976
Edmark C, McPhail MJW, Bell M, Whitehouse T, Wendon J et al (2016) LiFe: a liver injury score to predict outcome in critically ill patients. Intensive Care Med 42(3):361–369. https://doi.org/10.1007/s00134-015-4203-5
doi: 10.1007/s00134-015-4203-5
pubmed: 26820880
Sundaram V, Patel S, Shetty K, Lindenmeyer CC, Rahimi RS, Flocco G, Multi-Organ Dysfunction and Evaluation for Liver Transplantation (MODEL) Consortium et al (2022) Risk factors for post-transplantation mortality in recipients with grade 3 acute-on-chronic liver failure: analysis of a North American Consortium. Liver Transpl 28(6):1078–1089. https://doi.org/10.1002/lt.26408
doi: 10.1002/lt.26408
pubmed: 35020260
pmcid: 9117404
Belli LS, Duvoux C, Artzner T, Bernal W, Conti S, Cortesi PA, ELITA/EF-CLIF Working Group et al (2021) Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: results of the ELITA/EF-CLIF collaborative study (ECLIS). J Hepatol 75(3):610–622. https://doi.org/10.1016/j.jhep.2021.03.030
doi: 10.1016/j.jhep.2021.03.030
pubmed: 33951535
VanWagner LB, Harinstein ME, Runo JR, Darling C, Serper M, Hall S et al (2018) Multidisciplinary approach to cardiac and pulmonary vascular disease risk assessment in liver transplantation: an evaluation of the evidence and consensus recommendations. Am J Transplant 18(1):30–42. https://doi.org/10.1111/ajt.14531
doi: 10.1111/ajt.14531
pubmed: 28985025
Cheng XS, VanWagner LB, Costa SP, Axelrod DA, Bangalore S, Norman SP, American Heart Association Council on the Kidney in Cardiovascular Disease and Council on Cardiovascular Radiology and Intervention et al (2022) Emerging evidence on coronary heart disease screening in kidney and liver transplantation candidates: a scientific statement from the American Heart Association: endorsed by the American Society of Transplantation. Circulation 146(21):e299–e324. https://doi.org/10.1161/CIR.0000000000001104
doi: 10.1161/CIR.0000000000001104
pubmed: 36252095
Nanchal R, Subramanian R, Alhazzani W, Dionne JC, Peppard WJ, Singbartl K et al (2023) Guidelines for the management of adult acute and acute-on-chronic liver failure in the ICU: neurology, peri-transplant medicine, infectious disease, and gastroenterology considerations. Crit Care Med 51(5):657–676. https://doi.org/10.1097/CCM.0000000000005824
doi: 10.1097/CCM.0000000000005824
pubmed: 37052436
McPhail MJ, Shawcross DL, Abeles RD, Chang A, Patel V, Lee GH et al (2015) Increased survival for patients with cirrhosis and organ failure in liver intensive care and validation of the chronic liver failure-sequential organ failure scoring system. Clin Gastroenterol Hepatol 13(7):1353-1360.e8. https://doi.org/10.1016/j.cgh.2014.08.041
doi: 10.1016/j.cgh.2014.08.041
pubmed: 25240417
Galbois A, Trompette ML, Das V, Boëlle PY, Carbonell N, Thabut D et al (2012) Improvement in the prognosis of cirrhotic patients admitted to an intensive care unit, a retrospective study. Eur J Gastroenterol Hepatol 24(8):897–904. https://doi.org/10.1097/MEG.0b013e3283544816
doi: 10.1097/MEG.0b013e3283544816
pubmed: 22569082
McPhail MJW, Parrott F, Wendon JA, Harrison DA, Rowan KA, Bernal W (2018) Incidence and outcomes for patients with cirrhosis admitted to the United Kingdom critical care units. Crit Care Med 46(5):705–712. https://doi.org/10.1097/CCM.0000000000002961
doi: 10.1097/CCM.0000000000002961
pubmed: 29309369
pmcid: 5899891
O’Brien AJ, Welch CA, Singer M, Harrison DA (2012) Prevalence and outcome of cirrhosis patients admitted to UK intensive care: a comparison against dialysis-dependent chronic renal failure patients. Intensive Care Med 38(6):991–1000. https://doi.org/10.1007/s00134-012-2523-2
doi: 10.1007/s00134-012-2523-2
pubmed: 22456768
Staufer K, Roedl K, Kivaranovic D, Drolz A, Horvatits T, Rasoul-Rockenschaub S et al (2017) Renal replacement therapy in critically ill liver cirrhotic patients-outcome and clinical implications. Liver Int 37(6):843–850. https://doi.org/10.1111/liv.13389
doi: 10.1111/liv.13389
pubmed: 28211257
Cholongitas E, Betrosian A, Senzolo M, Shaw S, Patch D, Manousou P et al (2008) Prognostic models in cirrhotics admitted to intensive care units better predict outcome when assessed at 48 h after admission. J Gastroenterol Hepatol 23(8 Pt 1):1223–1227. https://doi.org/10.1111/j.1440-1746.2007.05269.x
doi: 10.1111/j.1440-1746.2007.05269.x
pubmed: 18086109
Das V, Boelle PY, Galbois A, Guidet B, Maury E, Carbonell N et al (2010) Cirrhotic patients in the medical intensive care unit: early prognosis and long-term survival. Crit Care Med 38(11):2108–2116. https://doi.org/10.1097/CCM.0b013e3181f3dea9
doi: 10.1097/CCM.0b013e3181f3dea9
pubmed: 20802324
Karvellas CJ, Garcia-Lopez E, Fernandez J, Saliba F, Sy E, Jalan R, Chronic Liver Failure Consortium and European Foundation for the Study of Chronic Liver Failure et al (2018) Dynamic prognostication in critically ill cirrhotic patients with multiorgan failure in ICUs in Europe and North America: a multicenter analysis. Crit Care Med 46(11):1783–1791. https://doi.org/10.1097/CCM.0000000000003369
doi: 10.1097/CCM.0000000000003369
pubmed: 30106759
Engelmann C, Thomsen KL, Zakeri N, Sheikh M, Agarwal B, Jalan R et al (2018) Validation of CLIF-C ACLF score to define a threshold for futility of intensive care support for patients with acute-on-chronic liver failure. Crit Care 22(1):254. https://doi.org/10.1186/s13054-018-2156-0
doi: 10.1186/s13054-018-2156-0
pubmed: 30305132
pmcid: 6180662
Jalan R, Gustot T, Fernandez J, Bernal W (2021) “Equity” and “Justice” for patients with acute-on chronic liver failure: a call to action. J Hepatol 75(5):1228–1235. https://doi.org/10.1016/j.jhep.2021.06.017
doi: 10.1016/j.jhep.2021.06.017
pubmed: 34171434
Artzner T, Michard B (2020) Caring for cirrhotic patients with multiple organ failure in the ICU: a change of paradigm is underway. Crit Care Med 48(9):e842–e843. https://doi.org/10.1097/CCM.0000000000004403
doi: 10.1097/CCM.0000000000004403
pubmed: 32826499
Artzner T, Fernandez J, Jalan R (2023) Liver transplantation for patients with severe acute on chronic liver failure: it is time to change paradigms. Intensive Care Med. https://doi.org/10.1007/s00134-023-07041-8
doi: 10.1007/s00134-023-07041-8
pubmed: 37552333
Artzner T, Bernal W, Belli LS, Conti S, Cortesi PA, Sacleux SC, ELITA/EF-CLIF Working Group et al (2022) Location and allocation: inequity of access to liver transplantation for patients with severe acute-on-chronic liver failure in Europe. Liver Transpl 28(9):1429–1440. https://doi.org/10.1002/lt.26499
doi: 10.1002/lt.26499
pubmed: 35544360
Artzner T, Belli LS, Faitot F, Jalan R (2023) Attitudes toward liver transplantation for ACLF-3 determine equity of access. J Hepatol 78(3):e93–e95. https://doi.org/10.1016/j.jhep.2022.10.029
doi: 10.1016/j.jhep.2022.10.029
pubmed: 36347330
Saliba F, Bañares R, Larsen FS, Wilmer A, Parés A, Mitzner S et al (2022) Artificial liver support in patients with liver failure: a modified DELPHI consensus of international experts. Intensive Care Med 48(10):1352–1367. https://doi.org/10.1007/s00134-022-06802-1
doi: 10.1007/s00134-022-06802-1
pubmed: 36066598
Ocskay K, Kanjo A, Gede N, Szakács Z, Pár G, Erőss B et al (2021) Uncertainty in the impact of liver support systems in acute-on-chronic liver failure: a systematic review and network meta-analysis. Ann Intensive Care 11(1):10. https://doi.org/10.1186/s13613-020-00795-0
doi: 10.1186/s13613-020-00795-0
pubmed: 33462764
pmcid: 7813174
Kanjo A, Ocskay K, Gede N, Kiss S, Szakács Z, Párniczky A et al (2021) Efficacy and safety of liver support devices in acute and hyperacute liver failure: a systematic review and network meta-analysis. Sci Rep 11(1):4189. https://doi.org/10.1038/s41598-021-83292-z
doi: 10.1038/s41598-021-83292-z
pubmed: 33602961
pmcid: 7893063
Agarwal B, Bañares Cañizares R, Saliba F, Ballester MP, Tomescu DR, Martin D et al (2023) Randomized-controlled trial of the DIALIVE liver dialysis device vs. standard of care in patients with acute-on-chronic liver failure. J Hepatol 79:79–92
doi: 10.1016/j.jhep.2023.03.013
pubmed: 37268222
https://clinicaltrials.gov/ct2/show/NCT03702920
Artru F, Louvet A, Ruiz I, Levesque E, Labreuche J, Ursic-Bedoya J et al (2017) Liver transplantation in the most severely ill cirrhotic patients: a multicenter study in acute-on-chronic liver failure grade 3. J Hepatol 67(4):708–715. https://doi.org/10.1016/j.jhep.2017.06.009
doi: 10.1016/j.jhep.2017.06.009
pubmed: 28645736
Karvellas CJ, Francoz C, Weiss E (2021) Liver transplantation in acute-on-chronic liver failure. Transplantation 105(7):1471–1481. https://doi.org/10.1097/TP.0000000000003550
doi: 10.1097/TP.0000000000003550
pubmed: 33208692
Artru F, Goldberg D, Kamath PS (2023) Should patients with acute-on-chronic liver failure grade 3 receive higher priority for liver transplantation? J Hepatol 78(6):1118–1123
doi: 10.1016/j.jhep.2022.12.026
pubmed: 37208098
Weiss E, Saner F, Asrani SK, Biancofiore G, Blasi A, Lerut J et al (2021) When is a critically ill cirrhotic patient too sick to transplant? Development of consensus criteria by a multidisciplinary panel of 35 international experts. Transplantation 105(3):561–568. https://doi.org/10.1097/TP.0000000000003364
doi: 10.1097/TP.0000000000003364
pubmed: 32568955
Hernaez R, Karvellas CJ, Liu Y, Sacleux SC, Khemichian S, Stein LL, et al., Multi-Organ Dysfunction and Evaluation for Liver Transplantation (MODEL) Consortium (2023) The novel SALT-M score predicts 1-year post-transplant mortality in patients with severe acute-on-chronic liver failure. J Hepatol S0168–8278(23):403–408. doi: https://doi.org/10.1016/j.jhep.2023.05.028
doi: 10.1016/j.jhep.2023.05.028
https://clinicaltrials.gov/ct2/show/NCT04613921
Hernaez R, Patel A, Jackson LK, Braun UK, Walling AM, Rosen HR (2020) Considerations for prognosis, goals of care, and specialty palliative care for hospitalized patients with acute-on-chronic liver failure. Hepatology 72(3):1109–1116. https://doi.org/10.1002/hep.31316
doi: 10.1002/hep.31316
pubmed: 32416642