Alcohol-related liver disease in patients admitted to intensive care unit: how to define alcohol consumption?

2021 ◽  
Vol 56 (5) ◽  
pp. 559-559
Author(s):  
Gianni Testino ◽  
Sharmila Fagoonee ◽  
Patrizia Balbinot ◽  
Rinaldo Pellicano
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Disease ◽  
Alcohol Consumption ◽  
Related Liver Disease

Quantification of Thrombelastographic Changes After Blood Component Transfusion in Patients with Liver Disease in the Intensive Care Unit

1995 ◽  
Vol 81 (2) ◽  
pp. 272-278
Author(s):  
Douglas G. Clayton ◽  
Adelaida M. Miro ◽  
David J. Kramer ◽  
Nathaniel Rodman ◽  
Stanley Wearden
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Disease ◽  
Blood Component ◽  
Blood Component Transfusion

scholarly journals THE COST OF ADULT LIVER TRANSPLANTATION IN A REFERRAL CENTER IN SOUTHERN BRAZIL

2019 ◽  
Vol 56 (2) ◽  
pp. 165-171 ◽  
Author(s):  
Adriane B de SOUZA ◽  
Santiago RODRIGUEZ ◽  
Fábio Luís da MOTTA ◽  
Ajacio B de Mello BRANDÃO ◽  
Claudio Augusto MARRONI
Keyword(s):  
Intensive Care Unit ◽  
Liver Transplantation ◽  
Intensive Care ◽  
Liver Disease ◽  
Southern Brazil ◽  
Referral Center ◽  
End Stage Liver Disease ◽  
End Stage ◽  
The Cost ◽  
Surgical Unit

ABSTRACT BACKGROUND: Liver transplantation (LTx) is the primary and definitive treatment of acute or chronic cases of advanced or end-stage liver disease. Few studies have assessed the actual cost of LTx categorized by hospital unit. OBJECTIVE: To evaluate the cost of LTx categorized by unit specialty within a referral center in southern Brazil. METHODS: We retrospectively reviewed the medical records of 109 patients undergoing LTx between April 2013 and December 2014. Data were collected on demographic characteristics, etiology of liver disease, and severity of liver disease according to the Child-Turcotte-Pugh (CTP) and Model for End-stage Liver Disease (MELD) scores at the time of LTx. The hospital bill was transformed into cost using the full absorption costing method, and the costs were grouped into five categories: Immediate Pretransplant Kit; Specialized Units; Surgical Unit; Intensive Care Unit; and Inpatient Unit. RESULTS: The mean total LTx cost was US$ 17,367. Surgical Unit, Specialized Units, and Intensive Care Unit accounted for 31.9%, 26.4% and 25.3% of the costs, respectively. Multivariate analysis showed that total LTx cost was significantly associated with CTP class C (P=0.001) and occurrence of complications (P=0.002). The following complications contributed to significantly increase the total LTx cost: septic shock (P=0.006), massive blood transfusion (P=0.007), and acute renal failure associated with renal replacement therapy (dialysis) (P=0.005). CONCLUSION: Our results demonstrated that the total cost of LTx is closely related to liver disease severity scores and the development of complications.

Alcoholic liver disease in the intensive care unit: Outcomes and predictors of prognosis

2014 ◽  
Vol 29 (6) ◽  
pp. 1131.e7-1131.e13 ◽  
Author(s):  
S. Fröhlich ◽  
N. Murphy ◽  
T. Kong ◽  
R. Ffrench-O’Carroll ◽  
N. Conlon ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Disease ◽  
Alcoholic Liver Disease

scholarly journals Ondansetron to Treat Pruritus Due to Cholestatic Jaundice

2013 ◽  
Vol 18 (3) ◽  
pp. 241-346 ◽  
Author(s):  
Sarah Dillon ◽  
Joseph D. Tobias
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Disease ◽  
Treatment Options ◽  
Symptomatic Treatment ◽  
Cholestatic Jaundice ◽  
Cholestatic Liver Disease ◽  
Opioid Antagonists

Intractable itching is a symptom of cholestatic liver disease of various causes that is bothersome and difficult to manage. Although treatment of the primary cause of cholestasis is paramount in resolving the issue, given the debilitating consequences of pruritus, symptomatic treatment is frequently necessary. Although many medications including cholestyramine, rifampin, opioid antagonists (i.e., naloxone, naltrexone), phenobarbital, and antihistamines have been used to treat cholestatic-induced pruritus, none has resulted in uniform success. We report anecdotal success with the use of ondansetron to treat pruritus associated with cholestasis following prolonged intensive care unit course of a 16-year-old. The theories accounting for pruritus with cholestasis are presented, treatment options are reviewed, and the role of ondansetron in the treatment of pruritus is discussed.

scholarly journals Influence of Tigecycline on Liver Function in Adult Patients in the Intensive Care Unit

2021 ◽  
Author(s):  
Jingnan Song ◽  
Pan Chen ◽  
Zhaoxia Tang ◽  
Yifan Zheng ◽  
Xiao Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Regression Analysis ◽  
Intensive Care ◽  
Liver Disease ◽  
Liver Injury ◽  
Liver Function ◽  
Adult Patients ◽  
Apache Ii Score ◽  
Cox Regression Analysis

Abstract Background There are few studies investigating TGC-associated hepatotoxicity in ICU patients, and the pathogenesis of hepatotoxicity and identification of risk factors are limited. Objectives To analyze the influence of tigecycline (TGC) on liver function in adult patients in the Intensive Care Unit to identify potential risk factors for tigecycline-induced liver injury (TILI). Methods Patients receiving tigecycline treatment in ICU during January 2019 to October 2020 were retrospectively enrolled. The liver function parameters before and after tigecycline treatment were collected, and risk factors associated with TILI was identified by logistic regression analysis. The probability of 28-day mortality was determined in Cox regression analysis. Results A total of 242 patients were enrolled, and TILI was identified in 24 patients (9.92%), of whom 75.0% had grade 1 liver injury, and 16.67%, 4.17%, 4.17% had grade 2 to 4 liver injury, respectively. The pattern of hepatotoxicity was hepatocellular in 16 patients (66.67%), cholestatic in 4 patients (16.67%), and mixed in 4 patients (16.67%). The median time from tigecycline start to symptoms was only 5 days (IQR, 3-7 days). Multivariate analysis identified tigecycline dose ≥ 200mg/day, longer course of treatment and preexisting liver disease tend to be independently associated with TILI. In addition, APACHE II score > 15, higher dose of tigecycline and TILI were independent risk factors of 28-day mortality, while longer course of tigecycline reduced this risk despite its association with TILI. Conclusions The maintenance dose and course of tigecycline, as well as liver disease is considered as risk factors of hepatotoxicity. 28-day mortality tended to be higher in TILI patients. The relationships among tigecycline dose and course, TILI and mortality should be further investigated.

Patterns and Severity of Alcohol Consumption in Patients with Alcoholic Liver Disease: A Cross-Sectional Study

2021 ◽  
Vol 18 (2) ◽  
pp. 9-12
Author(s):  
Niju Niroula
Keyword(s):  
Liver Disease ◽  
Alcohol Consumption ◽  
Alcoholic Liver Disease ◽  
Cross Sectional Study ◽  
Drinking Patterns ◽  
Sectional Study ◽  
Cross Sectional ◽  
Audit Score ◽  
The Mean ◽  
Related Liver Disease

Introduction: Alcohol is a known cause of liver cirrhosis, with its incidence increasing in relation to the total amount and duration of intake. Excessive consumption of alcohol remains the main cause of alcohol-related liver disease and associated complications and deaths. Aims: To delineate the drinking patterns and severity of alcohol consumption in alcoholic liver disease patients. Methods: A descriptive cross sectional study was conducted among 95 patients of both sexes with the diagnosis of alcoholic liver disease (ALD), who were admitted in Medicine ward at Nepalgunj Medical College, Nepalgunj. The diagnosis of ALD was confirmed by the criteria of the ICD-10-CM. The severity of alcohol drinking screened and categorized as “low-risk drinkers,” “hazardous drinkers,” and “harmful drinkers” were based on the AUDIT score. Results: Among a total of 95 ALD patients, the mean age was 45.10 ±7.60 years, the mean duration of alcohol use was 22.6 ±7.65 years and the average amount of alcohol consumed in grams/day was 240 ± 35. Majority of the patients consumed locally brewed alcohol, Raksi 46.3% followed by Jaad 22.1% and Others 11.6%. Very few patients consumed commercially available Spirits 6.3% or Beer 13.7%. Majority of patients were found to be drinking regular with intermittent bingeing pattern 61%, outside meal times 69.5% and hazardous drinking 53.7%. Conclusion: Overall our analyses indicated a precise picture of drinking patterns in ALD patients that are profoundly influenced on several cofactors like alcohol type, duration of exposure, drinking patterns, cultural habits, availability of homemade beverages and individual susceptibility. We recommend screening for alcohol abuse in all adult patients presenting to the hospital as early detection of ALD can decrease its both morbidity and mortality.

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