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Intensive care liver

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https://www.readbyqxmd.com/read/28542386/correlation-between-plasma-endothelin-1-levels-and-severity-of-septic-liver-failure-quantified-by-maximal-liver-function-capacity-limax-test-a-prospective-study
#1
Magnus F Kaffarnik, Navid Ahmadi, Johan F Lock, Tilo Wuensch, Johann Pratschke, Martin Stockmann, Maciej Malinowski
AIM: To investigate the relationship between the degree of liver dysfunction, quantified by maximal liver function capacity (LiMAx test) and endothelin-1, TNF-α and IL-6 in septic surgical patients. METHODS: 28 septic patients (8 female, 20 male, age range 35-80y) were prospectively investigated on a surgical intensive care unit. Liver function, defined by LiMAx test, and measurements of plasma levels of endothelin-1, TNF-α and IL-6 were carried out within the first 24 hours after onset of septic symptoms, followed by day 2, 5 and 10...
2017: PloS One
https://www.readbyqxmd.com/read/28542272/factors-associated-with-poor-outcomes-of-continuous-renal-replacement-therapy
#2
Chih-Chin Kao, Ju-Yeh Yang, Likwang Chen, Chia-Ter Chao, Yu-Sen Peng, Chih-Kang Chiang, Jenq-Wen Huang, Kuan-Yu Hung
Continuous renal replacement therapy (CRRT) is one of the dialysis modalities for critically ill patients. Despite intensive dialysis care, a high mortality rate is found in these patients. Our objective was to investigate the factors associated with poor outcomes in these patients. We conducted a retrospective cohort study using the National Health Insurance Research Database. Records of critically ill patients who received CRRT between 2007 and 2011 were retrieved, and the patients were categorized into two groups: those with acute kidney injury (AKI) and those with history of end-stage renal disease (ESRD)...
2017: PloS One
https://www.readbyqxmd.com/read/28538851/-antimicrobial-sensitivity-of-the-environmental-microbiota-in-the-intensive-care-units-of-a-peruvian-hospital
#3
José Díaz-Tello, Jesús Rojas-Jaimes, Jimmy Ibarra-Trujillo, Delza Tárraga-Gonzales
The objective was to detect Gram-negative bacilli and Gram-positive cocci isolated from the environmental microbiota of the Intensive Care Unit (ICU) departments of Neonatology, Pediatrics, and Transplants (kidney, liver, and general) in a Lima hospital and determine their antimicrobial sensitivity. Eighty samples were obtained from inanimate surfaces using a wet swab. A total of 61 bacterial strains were identified, including Staphylococcus epidermis (46.0%), Alcaligenes sp. (21.3%), Pseudomonas aeruginosa (16...
January 2017: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/28533998/ipilimumab-as-a-cause-of-severe-pan-colitis-and-colonic-perforation
#4
Raj Shah, Danielle Witt, Talal Asif, Fahad F Mir
Ipilimumab is a human monoclonal antibody that functions as a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor that is used to treat malignant melanoma. Due to ipilimumab's removal of immune regulation, specifically through the inactivation of CTLA-4, it is commonly associated with inflammatory and autoimmune events. Gastrointestinal (GI) related immune-related adverse events such as diarrhea occur in 29% of patients with 7.6% of patients specifically suffering from colitis. We describe a case of colonic perforation with ipilimumab use...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28533667/octogenarian-liver-grafts-is-their-use-for-transplant-currently-justified
#5
Carlos Jiménez-Romero, Felix Cambra, Oscar Caso, Alejandro Manrique, Jorge Calvo, Alejandro Marcacuzco, Paula Rioja, David Lora, Iago Justo
AIM: To analyse the impact of octogenarian donors in liver transplantation. METHODS: We present a retrospective single-center study, performed between November 1996 and March 2015, that comprises a sample of 153 liver transplants. Recipients were divided into two groups according to liver donor age: recipients of donors ≤ 65 years (group A; n = 102), and recipients of donors ≥ 80 years (group B; n = 51). A comparative analysis between the groups was performed...
May 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28527198/contrast-enhanced-ultrasound-ceus-in-an-interdisciplinary-intensive-care-unit-icu-diagnostic-efficacy-in-the-assessment-of-post-operative-complications-compared-to-contrast-enhanced-computed-tomography-cect-first-results
#6
M Georgieva, L Beyer, I Goecze, C Stroszczynski, P Wiggermann, E M Jung
To evaluate the effectiveness of high-resolution contrast-enhanced ultrasound (CEUS) to diagnose early post-operative complications in an interdisciplinary intensive care unit.In 50 patients (male 32; female 18) 64 CEUS examinations were performed in an intensive care unit (ICU) setting to detect post-operative complications. Multi-frequency transducer (1-5 and/or 6-9 MHz) were used. All 64 examinations were performed by one experienced examiner. CEUS findings were compared with contrast-enhanced computed tomography (CECT) findings...
May 19, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28511674/predictors-of-fifty-days-in-hospital-mortality-in-patients-with-culture-negative-neutrocytic-ascites
#7
Chinmaya Kumar Bal, Vikram Bhatia, Ripu Daman
BACKGROUND: Culture negative neutrocytic ascites is a variant of spontaneous bacterial peritonitis. But there are conflicting reports regarding the mortality associated with culture negativeneutrocytic ascites. Therefore we aim to determine the predictors of mortality associated with culture negativeneutrocytic ascites in a larger sample population. METHODS: We analysed 170 patients consecutively admitted to intensive care unit with diagnosis of culture negative neutrocytic ascites...
May 16, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28503510/a-case-report-of-the-nutrition-support-for-a-patient-with-hellp-syndrome
#8
Seo Eun Yeon, Sun Jung Kim, Ju Hee Kim, Hae-Yun Chung, Se Hee Na, Song Mi Lee
A 30-year-old female patient, 18 weeks gestational age, with no prior medical history was admitted to hospital complaining severe right upper quadrant pain. The patient was admitted to intensive care unit (ICU) after emergency surgery to treat intraperitoneal hemorrhage caused by rupture of liver hematoma. Despite the absence of high blood pressure, the patient was diagnosed with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome on the basis of abnormal levels of blood aspartate aminotransferase/alanine aminotransferase, lactate dehydrogenase, total bilirubin, direct bilirubin, C-reactive protein (CRP) and platelet along with liver damage and proteinuria...
April 2017: Clinical Nutrition Research
https://www.readbyqxmd.com/read/28498944/assessment-of-standard-laboratory-tests-and-rotational-thromboelastometry-for-the-prediction-of-postoperative-bleeding-in-liver-transplantation
#9
T M Dötsch, D Dirkmann, D Bezinover, M Hartmann, J W Treckmann, A Paul, F H Saner
Background.: Perioperative bleeding remains a major challenge in liver transplantation. We aimed to compare standard laboratory tests with thromboelastometry (ROTEM ® ) with regard to their ability to predict postoperative non-surgical bleeding. Methods.: Data from 243 adult liver transplant recipients from January 2012 to May 2014 were evaluated retrospectively. Upon admission to the intensive care unit, coagulation status was assessed using standard laboratory tests [prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen concentration, and platelet count] and ROTEM ® whole blood coagulation assays...
May 12, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28491434/life-threatening-haematological-complication-occurring-in-a-cat-after-chronic-carbimazole-administration
#10
Andrea Mosca, Luca Bresciani
CASE SUMMARY: An 11-year-old spayed female domestic shorthair cat with a history of hyperthyroidism treated with carbimazole for 7 months was presented for a check-up after a few episodes of vomiting. The cat had been receiving prednisolone at 0.5 mg/kg PO q12h for recent pancreatitis and concurrent inflammation of liver and small intestines confirmed by biopsies. Clinical examination revealed pale mucous membranes with a capillary refill time of <2 s. Haematology showed severely decreased packed cell volume (16%), and increased prothrombin time (42 s), partial thromboplastin time (>120 s) and fibrinogen serum concentration (3...
July 2016: JFMS Open Rep
https://www.readbyqxmd.com/read/28489448/immediate-postoperative-management-and-complications-on-the-intensive-care-unit
#11
Eleanor Bates, Daniel Martin
The postoperative management of patients immediately after liver transplantation requires knowledge of this complex surgery and the physiology that accompanies liver failure. A multidisciplinary approach to the care of these patients is essential in order to reduce postoperative complications and preserve function in the transplanted organ. By their nature, patients undergoing liver transplantation have complicated medical problems before surgery which must be borne in mind when managing them after surgery...
May 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28488418/systematic-review-with-meta-analysis-post-operative-complications-and-mortality-risk-in-liver-transplant-candidates-with-obesity
#12
REVIEW
M Barone, M T Viggiani, G Losurdo, M Principi, G Leandro, A Di Leo
BACKGROUND: International guidelines rate class III (morbid) obesity (body mass index [BMI]≥40 kg/m(2) ) as a relative contraindication for liver transplantation (LT) requiring further research. Moreover, data on the mortality risk in candidates with a BMI: 30-34.9 and 35-39.9 kg/m(2) (class I and class II obesity, respectively) are weak. AIM: Herein, we compared post-operative complications and mortality risks in all obese candidates vs candidates with a BMI: 18...
May 10, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28484088/radium-223-for-primary-bone-metastases-in-patients-with-hormone-sensitive-prostate-cancer-after-radical-prostatectomy
#13
Vera Wenter, Annika Herlemann, Wolfgang P Fendler, Harun Ilhan, Natalia Tirichter, Peter Bartenstein, Christian G Stief, Christian la Fougère, Nathalie L Albert, Axel Rominger, Christian Gratzke
Radium-223 dichloride (Ra-223) is the first bone-targeting agent showing improvement in overall survival in patients with castration-resistant prostate cancer (CRPC) and bone metastases. We aimed to assess feasibility of Ra-223 treatment in patients with metastatic hormone-sensitive prostate cancer (mHSPC). Ten patients with primary bone metastases received Ra-223 following radical prostatectomy (RP). Changes in alkaline phosphatase (ALP) and prostate-specific antigen (PSA) were recorded, while pain intensity was evaluated using the self-reporting Brief Pain Inventory (BPI) questionnaire...
April 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/28471439/relationships-between-cerebral-autoregulation-and-markers-of-kidney-and-liver-injury-in-neonatal-encephalopathy-and-therapeutic-hypothermia
#14
J K Lee, J Perin, C Parkinson, M O'Connor, M M Gilmore, M Reyes, J Armstrong, J M Jennings, F J Northington, R Chavez-Valdez
OBJECTIVE: We studied whether cerebral blood pressure autoregulation and kidney and liver injuries are associated in neonatal encephalopathy (NE). STUDY DESIGN: We monitored autoregulation of 75 newborns who received hypothermia for NE in the neonatal intensive care unit to identify the mean arterial blood pressure with optimized autoregulation (MAPOPT). Autoregulation parameters and creatinine, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were analyzed using adjusted regression models...
May 4, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28466289/-personalised-pharmacotherapy-in-intensive-care-unit-patients
#15
R Bellmann
Critically ill patients need fast, effective and safe pharmacotherapy. The pharmacokinetics and pharmacodynamics of the administered drugs are influenced by numerous individual conditions. Genetic factors mainly determines drug metabolism. However, therapeutic decisions are not yet guided by genetic analyses. In elderly patients, the volume of distribution can be altered and renal elimination may be delayed. Drug-drug interactions involving current medications can increase the incidence of adverse effects from treatment in the intensive care unit...
May 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28457412/factors-related-to-hepatocellular-carcinoma-recurrence-after-liver-transplantation-a-brazilian-multicenter-study
#16
M Bina Possatto, E C de Ataíde, C A Fazzio Escanhoela, T Sevá-Pereira, R de Cassia Martins Alves da Silva, H Felicio, L R de Navarro Amado, R Ferreira da Silva, A Soares Lima, I F S F Boin
BACKGROUND: Liver transplantation (LT) is a curative treatment option for hepatocellular carcinoma (HCC); recurrent HCC after liver transplantation (HCC-R) is diagnosed in 9%-16%. The objective of this study was to evaluate which factors are associated with R-HCC after liver transplantation. METHODS: This retrospective real-life study analyzed 278 LTs from 3 reference centers (2,093 LTs) in Brazil from 1988 to 2015. HCC-R with histologic confirmation was seen in 40 patients (14...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28457408/hepatic-transplants-in-espirito-santo-state-brazil
#17
S S Lauer, G P S Miguel, I W de Abreu, A B Stein
BACKGROUND: The Meridional Hospital Liver transplant unit is the only one active in all Espírito Santo State, Brazil, since 2004. OBJECTIVE: The aim is to analyze data of the first 250 transplants performed by the team. METHODS: This retrospective study reviewed files from patients transplanted in the Meridional Hospital from January 2005 to December 2015. RESULTS: There were 250 liver transplants in 236 patients and 14 retransplants...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28457370/carbapenem-resistant-klebsiella-pneumoniae-infections-early-after-liver-transplantation-a-single-center-experience
#18
E Mazza, M Prosperi, M F Panzeri, R Limuti, M Nichelatti, A De Gasperi
The aims of this study were to define in a cohort of 310 liver transplant recipients, the incidence of post-liver transplantation (LT) non-carbapenem-resistant Klebsiella pneumoniae (CRKP) and CRKP infections, pre- and post-LT CRKP colonization, CRKP-associated mortality, and risk factors for non-CRKP and CRKP infections. Every patient was screened for CRKP immediately before and after LT. The 6-month survival rate was 95%. Fifty-two patients became infected (16.5%): 8 by CRKP (2.5%) and 44 (14%) by a non-CRKP micro-organism...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28447929/five-year-follow-up-on-transplanted-organs-from-donors-after-brain-death-after-acute-stroke
#19
Vera Spatenkova, Eva Pokorna, Petr Suchomel
OBJECTIVES: Efficient intensive care donor management can help alleviate the shortage of organs for transplant. The aim of this study was to investigate the efficiency of management of donors after brain death from our neurointensive care unit. MATERIALS AND METHODS: We conducted a prospective observational 5-year follow-up on 29 transplanted organs from 14 brain-dead donors after acute stroke (7 subarachnoid and 4 intracerebral hemorrhages, 3 ischemic strokes)...
April 27, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28444411/-acute-liver-failure
#20
A Koch, C Trautwein, F Tacke
Acute liver failure (ALF) is a rare, but life-threatening disease that is characterized by the acute onset of jaundice, coagulopathy, and hepatic encephalopathy (HE) in patients without pre-existing liver disease. Main causes in Germany are drug toxicity, acetaminophen overdose, and viral hepatitis (A, B, E). For the initial assessment of patients with ALF and the diagnostic algorithm, the early detection of HE, exclusion of liver cirrhosis, immediate diagnosis of the underlying etiology, and evaluation for the necessity of liver transplantation (LT) are critical...
May 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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