Skip to main content

Chronic Liver Disease in the Intensive Care

  • Chapter
  • First Online:
Chronic Liver Failure

Part of the book series: Clinical Gastroenterology ((CG))

  • 1398 Accesses

Abstract

Chronic liver disease (CLD) accounts for a significant portion of the current health burden. If figures and projections are extrapolated from historical data for the viral hepatitides, particularly hepatitis C, then this is set to rise significantly over the coming decades. Furthermore, the incidence of alcoholic liver disease and non-alcoholic fatty liver disease will add to this workload, primarily due to the increased consumption of alcohol seen among the young, particularly young women, and the established epidemic of obesity in the Western world. The number of patients requiring both hospital and intensive care admission will consequently rise and demand substantial increases in health care budgets.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. O’Brien JM, Jr. et al. Alcohol dependence is independently associated with sepsis, septic shock, and hospital mortality among adult intensive care unit patients. Crit Care Med 2007;35(2):345–50.

    Article  PubMed  Google Scholar 

  2. Fang JT et al. Outcome predictors and new score of critically ill cirrhotic patients with acute renal failure. Nephrol Dial Transplant 2008;23(6):1961–9.

    Article  PubMed  Google Scholar 

  3. Gildea TR et al. Predictors of long-term mortality in patients with cirrhosis of the liver admitted to a medical ICU. Chest 2004;126(5):1598–603.

    Article  PubMed  Google Scholar 

  4. Koch DG, Arguedas MR, Fallon MB. Risk of aspiration pneumonia in suspected variceal hemorrhage: the value of prophylactic endotracheal intubation prior to endoscopy. Dig Dis Sci 2007; 52(9):2225–8.

    Article  PubMed  Google Scholar 

  5. Heikkinen M, Aarnio P, Hannukainen J. Percutaneous dilational tracheostomy or conventional surgical tracheostomy? Crit Care Med 2000;28(5):1399–402.

    Article  CAS  PubMed  Google Scholar 

  6. MacIntyre N. Discontinuing mechanical ventilatory support. Chest 2007;132(3):1049–56.

    Article  PubMed  Google Scholar 

  7. Auzinger G et al. Percutaneous tracheostomy in patients with severe liver disease and a high. Crit Care 2007;11(5):R110.

    Article  PubMed  Google Scholar 

  8. Huffmyer JL, Nemergut EC. Respiratory dysfunction and pulmonary disease in cirrhosis and other hepatic disorders. Respir Care 2007;52(8):1030–6.

    PubMed  Google Scholar 

  9. Mathurin S et al. [Infections in hospitalized patients with cirrhosis]. Medicina (B Aires) 2009;69(2):229–38.

    Google Scholar 

  10. Foreman MG, Mannino DM, Moss M. Cirrhosis as a risk factor for sepsis and death: analysis of the National Hospital Discharge Survey. Chest 2003;124(3):1016–20.

    Article  PubMed  Google Scholar 

  11. Senousy BE, Draganov PV. Evaluation and management of patients with refractory ascites. World J Gastroenterol 2009;15(1):67–80.

    Article  PubMed  Google Scholar 

  12. Graf J. Pleural effusion in the mechanically ventilated patient. Curr Opin Crit Care 2009; 15(1):10–7.

    Article  PubMed  Google Scholar 

  13. Sanyal AJ et al. A randomized, prospective, double-blind, placebo-controlled trial of terlipressin for type 1 hepatorenal syndrome. Gastroenterology 2008;134(5):1360–8.

    Article  CAS  PubMed  Google Scholar 

  14. Ortega R et al. Terlipressin therapy with and without albumin for patients with hepatorenal syndrome: results of a prospective, nonrandomized study. Hepatology 2002; 36(4 Pt 1): 941–8.

    CAS  PubMed  Google Scholar 

  15. Cordoba J et al. Normal protein diet for episodic hepatic encephalopathy: results of a randomized study. J Hepatol 2004;41(1): 38–43.

    Article  CAS  PubMed  Google Scholar 

  16. Hermans G et al. Clinical review: critical illness polyneuropathy and myopathy. Crit Care 2008;12(6):238.

    Article  PubMed  Google Scholar 

  17. Rodriguez-Roisin R, Krowka MJ. Hepatopulmonary syndrome – a liver-induced lung vascular disorder. N Engl J Med 2008;358(22):2378–87.

    Article  CAS  PubMed  Google Scholar 

  18. Mantz FA, Jr., Craige E. Portal axis thrombosis with spontaneous portacaval shunt and resultant cor pulmonale. AMA Arch Pathol 1951;52(1):91–7.

    PubMed  Google Scholar 

  19. Mandell MS, Groves BM. Pulmonary hypertension in chronic liver disease. Clin Chest Med 1996;17(1):17–33.

    Article  CAS  PubMed  Google Scholar 

  20. Roberts KE et al. Genetic risk factors for portopulmonary hypertension in patients with advanced liver disease. Am J Respir Crit Care Med 2009;179(9):835–42.

    Article  PubMed  Google Scholar 

  21. Kim WR et al. Accuracy of Doppler echocardiography in the assessment of pulmonary hypertension in liver transplant candidates. Liver Transpl 2000;6(4):453–8.

    Article  PubMed  Google Scholar 

  22. Martinez-Palli G et al. Liver transplantation in high-risk patients: hepatopulmonary syndrome and portopulmonary hypertension. Transplant Proc 2005;37(9):3861–4.

    Article  CAS  PubMed  Google Scholar 

  23. Moller S, Henriksen JH. Cirrhotic cardiomyopathy: a pathophysiological review of circulatory dysfunction in liver disease. Heart 2002;87(1):9–15.

    Article  CAS  PubMed  Google Scholar 

  24. Mandell MS et al. Cardiac evaluation of liver transplant candidates. World J Gastroenterol 2008;14(22): 3445–51.

    Article  PubMed  Google Scholar 

  25. Takabatake T et al. Low serum creatinine levels in severe hepatic disease. Arch Intern Med 1988;148(6):1313–5.

    Article  CAS  PubMed  Google Scholar 

  26. Jenq CC et al. RIFLE classification can predict short-term prognosis in critically ill cirrhotic patients. Intensive Care Med 2007;33(11):1921–30.

    Article  PubMed  Google Scholar 

  27. Gines P, Martin PY, Niederberger M. Prognostic significance of renal dysfunction in cirrhosis. Kidney Int Suppl 1997;61:S77–82.

    CAS  PubMed  Google Scholar 

  28. Garcia-Tsao G, Parikh CR, Viola A. Acute kidney injury in cirrhosis. Hepatology 2008;48(6):2064–77.

    Article  CAS  PubMed  Google Scholar 

  29. Lodhia N et al. Risk of contrast-induced nephropathy in hospitalized patients with cirrhosis. World J Gastroenterol 2009;15(12):1459–64.

    Article  CAS  PubMed  Google Scholar 

  30. Budhiraja P, Chen Z, Popovtzer M. Sodium bicarbonate versus normal saline for protection against contrast nephropathy. Ren Fail 2009;31(2):118–23.

    Article  CAS  PubMed  Google Scholar 

  31. Sanyal A et al. A randomized, prospective, double blind placebo-controlled trial of terlipressin for type I hepatorenal syndrome. Gastroenterology 2008;134(5):1360–8.

    Article  CAS  PubMed  Google Scholar 

  32. Martin-Lahi M et al. Terlipressin and albumin vs albumin in patients with cirrhosis and heptorenal syndrome: a randomized study. Gastroenterology 2008;134(5):1352–9.

    Article  Google Scholar 

  33. Gines A et al. Incidence, predictive factors, and prognosis of the hepatorenal syndrome in cirrhosis with ascites. Gastroenterology 1993;105(1):229–36.

    CAS  PubMed  Google Scholar 

  34. Bellomo R et al. Septic acute kidney injury: new concepts. Nephron Exp Nephrol 2008;109(4): e95–100.

    Article  PubMed  Google Scholar 

  35. Solanki P et al. Beneficial effects of terlipressin in hepatorenal syndrome: a prospective, randomized placebo-controlled clinical trial. J Gastroenterol Hepatol 2003;18(2):152–6.

    Article  CAS  PubMed  Google Scholar 

  36. Wong F, Pantea L, Sniderman K. Midodrine, octreotide, albumin, and TIPS in selected patients with cirrhosis and type 1 hepatorenal syndrome. Hepatology 2004;40(1): 55–64.

    Article  CAS  PubMed  Google Scholar 

  37. Tripodi A et al. The coagulopathy of cirrhosis assessed by thromboelastometry and its correlation with conventional coagulation parameters. Thromb Res 2009;124(1):132–6.

    Article  CAS  PubMed  Google Scholar 

  38. Morath C, et al. Sodium citrate anticoagulation during sustained low efficiency dialysis (SLED) in patients with acute renal failure and severely impaired liver function. Nephrol Dial Transplant 2008;23(1):421–2.

    Article  PubMed  Google Scholar 

  39. Albillos Martinez A. Survival of patients with cirrhosis after acute variceal bleeding. Rev Esp Enferm Dig 2009;101(4):231–5.

    Article  CAS  PubMed  Google Scholar 

  40. Lo GH et al. Low-dose terlipressin plus banding ligation versus low-dose terlipressin alone in the prevention of very early rebleeding of oesophageal varices. Gut 2009;58(9):1275–80.

    Article  CAS  PubMed  Google Scholar 

  41. Abid S et al. Terlipressin vs. octreotide in bleeding esophageal varices as an adjuvant therapy with endoscopic band ligation: a randomized double-blind placebo-controlled trial. Am J Gastroenterol 2009;104(3): 617–23.

    Article  CAS  PubMed  Google Scholar 

  42. Sempere L et al. Assessing the short- and long-term prognosis of patients with cirrhosis and acute variceal bleeding. Rev Esp Enferm Dig 2009;101(4):236–48.

    Article  CAS  PubMed  Google Scholar 

  43. Sharma BC et al. Secondary prophylaxis of hepatic encephalopathy: an open-label randomized controlled trial of lactulose versus placebo. Gastroenterology 2009;137(3):885–91, 891e1.

    Article  CAS  PubMed  Google Scholar 

  44. Wright G, Jalan R. Management of hepatic encephalopathy in patients with cirrhosis. Best Pract Res Clin Gastroenterol 2007;21(1):95–110.

    Article  PubMed  Google Scholar 

  45. Shawcross D, Jalan R. The pathophysiologic basis of hepatic encephalopathy: central role for ammonia and inflammation. Cell Mol Life Sci 2005;62(19–20):2295–304.

    Article  CAS  PubMed  Google Scholar 

  46. Shawcross D, Jalan R. Dispelling myths in the treatment of hepatic encephalopathy. Lancet 2005;365(9457):431–3.

    PubMed  Google Scholar 

  47. Shawcross DL et al. Systemic inflammatory response exacerbates the neuropsychological effects of induced hyperammonemia in cirrhosis. J Hepatol 2004;40(2):247–54.

    Article  CAS  PubMed  Google Scholar 

  48. Pugh RN et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 1973;60(8):646–9.

    Article  CAS  PubMed  Google Scholar 

  49. Angermayr B et al. Child–Pugh versus MELD score in predicting survival in patients undergoing transjugular intrahepatic portosystemic shunt. Gut 2003;52(6):879–85.

    Article  CAS  PubMed  Google Scholar 

  50. Malinchoc M et al. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology 2000;31(4):864–71.

    Article  CAS  PubMed  Google Scholar 

  51. Neuberger J et al. Selection of patients for liver transplantation and allocation of donated livers in the UK. Gut 2008;57(2):252–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Slack, A., Wendon, J. (2011). Chronic Liver Disease in the Intensive Care. In: Ginès, P., Kamath, P., Arroyo, V. (eds) Chronic Liver Failure. Clinical Gastroenterology. Humana Press. https://doi.org/10.1007/978-1-60761-866-9_27

Download citation

  • DOI: https://doi.org/10.1007/978-1-60761-866-9_27

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60761-865-2

  • Online ISBN: 978-1-60761-866-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics