Abstract:
BACKGROUND:Hypoxic hepatitis (HH) is a type of acute hepatic injury that is histologically characterized by centrilobular liver cell necrosis and that is caused by insufficient oxygen delivery to the hepatocytes. Typical for HH is the sudden and significant increase of aspartate aminotransferase (AST) in response to cardiac, circulatory or respiratory failure. The aim of this study is to investigate its epidemiology, causes, evolution and outcome. METHODS:The screened population consisted of all adults admitted to the intensive care unit (ICU) at the Ghent University Hospital between January 1, 2007 and September 21, 2015. HH was defined as peak AST > 5 times the upper limit of normal (ULN) after exclusion of other causes of liver injury. Thirty-five variables were retrospectively collected and used in descriptive analysis, time series plots and Kaplan-Meier survival curves with multi-group log-rank tests. RESULTS:HH was observed in 4.0% of the ICU admissions at our center. The study cohort comprised 1116 patients. Causes of HH were cardiac failure (49.1%), septic shock (29.8%), hypovolemic shock (9.4%), acute respiratory failure (6.4%), acute on chronic respiratory failure (3.3%), pulmonary embolism (1.4%) and hyperthermia (0.5%). The 28-day mortality associated with HH was 45.0%. Mortality rates differed significantly (P = 0.007) among the causes, ranging from 33.3% in the hyperthermia subgroup to 52.9 and 56.2% in the septic shock and pulmonary embolism subgroups, respectively. The magnitude of AST increase was also significantly correlated (P < 0.001) with mortality: 33.2, 44.4 and 55.4% for peak AST 5-10× ULN, 10-20× ULN and > 20× ULN, respectively. CONCLUSION:This study surpasses by far the largest cohort of critically ill patients with HH. HH is more common than previously thought with an ICU incidence of 4.0%, and it is associated with a high all-cause mortality of 45.0% at 28 days. The main causes of HH are cardiac failure and septic shock, which include more than 3/4 of all episodes. Clinicians should search actively for any underlying hemodynamic or respiratory instability even in patients with moderately increased AST levels.
journal_name
Ann Intensive Carejournal_title
Annals of intensive careauthors
Van den Broecke A,Van Coile L,Decruyenaere A,Colpaert K,Benoit D,Van Vlierberghe H,Decruyenaere Jdoi
10.1186/s13613-018-0356-zsubject
Has Abstractpub_date
2018-01-30 00:00:00pages
15issue
1issn
2110-5820pii
10.1186/s13613-018-0356-zjournal_volume
8pub_type
杂志文章abstract:BACKGROUND:In randomised controlled trials, procalcitonin (PCT)-guided antibiotic treatment has been proven to significantly reduce length of antibiotic therapy in intensive care unit (ICU) patients. However, concern was raised on low protocol adherence and high rates of overruling, and thus the value of PCT-guided tre...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0415-5
更新日期:2018-06-04 00:00:00
abstract:BACKGROUND:We assessed the association of intravenous insulin and glucose infusion with intensive care unit (ICU) and hospital mortality. METHODS:For this retrospective association study, we used data from all patients admitted to a medical-surgical ICU between January 2012 and September 2017. We excluded patients adm...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0507-x
更新日期:2019-02-11 00:00:00
abstract:BACKGROUND:Changeovers of norepinephrine infusion pumps (CNIPs) frequently lead to haemodynamic instability. The aim of this study was to identify risk factors for haemodynamic instability associated with CNIP, independent of the method used to perform the relay. METHODS:We performed a prospective study, in a universi...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0139-3
更新日期:2016-12-01 00:00:00
abstract:Introduction:Acute respiratory failure is the main reason for admission to the intensive care unit (ICU) in HIV-infected adults. There is little data about the epidemiology of respiratory viruses in this population. Methods:HIV-infected adults admitted to two intensive care units over a 6-year period for an acute resp...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00738-9
更新日期:2020-09-14 00:00:00
abstract:BACKGROUND:Despite advances in supportive care, moderate-severe acute respiratory distress syndrome (ARDS) is associated with high mortality rates, and novel therapies to treat this condition are needed. Compelling pre-clinical data from mouse, rat, sheep and ex vivo perfused human lung models support the use of human ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-014-0022-z
更新日期:2014-07-03 00:00:00
abstract::The 2018 Paris Intensive Care symposium entitled "Update in Neurocritical Care" was organized in Paris, June 21-22, 2018, under the auspices of the French Intensive Care Society. This 2-day post-graduate educational symposium comprised several chapters, aiming first to provide all-board intensivists with current stand...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-019-0523-x
更新日期:2019-04-16 00:00:00
abstract:BACKGROUND:Acute lung injury and the acute respiratory distress syndrome (ALI/ARDS) are characterized by pulmonary oedema, measured as extravascular lung water (EVLW). The chest radiograph (CXR) can potentially estimate the quantity of lung oedema while the transpulmonary thermodilution method measures the amount of EV...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-3-25
更新日期:2013-08-11 00:00:00
abstract::Jean-Luc Diehl The French Intensive Care Society organized on 5th and 6th June 2014 its 4th "Paris International Conference in Intensive Care", whose principle is to bring together the best international experts on a hot topic in critical care medicine. The 2014 theme was "Breakthrough in cardiac arrest", with many hi...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-015-0064-x
更新日期:2015-12-01 00:00:00
abstract:: Thrombocytopenia is a very frequent disorder in the intensive care unit. Many etiologies should be searched, and therapeutic approaches differ according to these different causes. However, no guideline exists regarding optimum practices for these situations in critically ill patients. We present recommendations for t...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-42
更新日期:2012-08-28 00:00:00
abstract:BACKGROUND:Hyponatremia occurring as a result of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) or cerebral salt wasting syndrome is a common complication in patients with subarachnoid hemorrhage (SAH). The efficacy and safety of urea as treatment for SIADH-induced hyponatremia has not been report...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-13
更新日期:2012-05-30 00:00:00
abstract::Although improving, the mortality from septic shock still remains high despite increased international awareness. As a consequence, much effort has focused on alternative treatment strategies in an effort to improve outcomes. The application of blood purification therapies to improve immune homeostasis has been sugges...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-019-0530-y
更新日期:2019-05-14 00:00:00
abstract:BACKGROUND:The value of goal-directed fluid therapy in neurosurgical patients, where brain swelling is a major concern, is unknown. The aim of our study was to evaluate the effect of an intraoperative goal-directed fluid restriction (GDFR) strategy on the postoperative outcome of high-risk patients undergoing brain sur...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0239-8
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The clinical interest of using bubble humidification of oxygen remains controversial. This study was designed to further explore whether delivering dry oxygen instead of bubble-moistened oxygen had an impact on discomfort of ICU patients. METHODS:This randomized multicenter non-inferiority open trial includ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0472-9
更新日期:2018-12-17 00:00:00
abstract:BACKGROUND:Infection and sepsis are a main cause of acute-on-chronic liver failure (ACLF). Adequate dosing of antimicrobial therapy is of central importance to improve outcome. Liver failure may alter antibiotic drug concentrations via changes of drug distribution and elimination. We studied the pharmacokinetics of mer...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00666-8
更新日期:2020-04-22 00:00:00
abstract:BACKGROUND:Preliminary reports have described significant procoagulant events in patients with coronavirus disease-2019 (COVID-19), including life-threatening pulmonary embolism (PE). MAIN TEXT:We review the current data on the epidemiology, the possible underlying pathophysiologic mechanisms, and the therapeutic impl...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-020-00741-0
更新日期:2020-09-16 00:00:00
abstract:BACKGROUND:Endotoxins can induce an excessive inflammatory response and result in microcirculatory dysfunction. Polymyxin-B hemoperfusion (PMX-HP) has been recognized to effectively remove endotoxins in patients with sepsis and septic shock, and a rat sepsis model revealed that PMX-HP treatment can maintain a better mi...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00699-z
更新日期:2020-06-12 00:00:00
abstract:UNLABELLED: BACKGROUND:A history of prolonged and excessive consumption of alcohol increases the risk for infections. The goal of this study was to investigate circulating white blood cells (WBC) differentiated by flow cytometry and neutrophil CD64 expression in excessive alcohol drinkers versus abstinent or moderate ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-50
更新日期:2012-12-31 00:00:00
abstract:BACKGROUND:Middle East respiratory syndrome (MERS) is caused by a coronavirus (MERS-CoV) and is characterized by hypoxemic respiratory failure. The objective of this study is to compare the outcomes of MERS-CoV patients before and after the availability of extracorporeal membrane oxygenation (ECMO) as a rescue therapy ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0350-x
更新日期:2018-01-10 00:00:00
abstract::The death of a loved one is often an ordeal and a tragedy for those who witness it, as death is not merely the end of a life, but also the end of an existence, the loss of a unique individual who is special and irreplaceable. In some situations, end-of-life signs, such as agonal gasps, can be an almost unbearable "sig...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/2110-5820-4-23
更新日期:2014-07-08 00:00:00
abstract:BACKGROUND:The consequences of the ageing population concerning ICU hospitalisation need to be adequately described. We believe that this discussion should be disease specific. A focus on respiratory infections is of particular interest, because it is strongly associated with old age. Our objective was to assess trends...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0430-6
更新日期:2018-08-15 00:00:00
abstract:BACKGROUND:Noninvasive ventilation (NIV) is the first-line treatment of adult patients with exacerbations of cystic fibrosis (CF). High-flow nasal oxygen therapy (HFNT) might benefit patients with hypoxemia and can reduce physiological dead space. We hypothesized that HFNT and NIV would similarly reduce work of breathi...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0432-4
更新日期:2018-09-05 00:00:00
abstract:BACKGROUND:Assessment of maximum respiratory pressures is a common practice in intensive care because it can predict the success of weaning from ventilation. However, the reliability of measurements through an intubation catheter has not been compared with standard measurements. The aim of this study was to compare max...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0362-1
更新日期:2018-01-30 00:00:00
abstract::In the past, the only treatment of acute exacerbations of obstructive diseases with hypercapnic respiratory failure refractory to medical treatment was invasive mechanical ventilation (IMV). Considerable technical improvements transformed extracorporeal techniques for carbon dioxide removal in an attractive option to ...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-019-0551-6
更新日期:2019-07-02 00:00:00
abstract:BACKGROUND:Among intensive care unit (ICU) patients with acute respiratory distress syndrome (ARDS), apart from acute cor pulmonale (ACP), the frequency and prognostic impact of basic critical care echocardiography (BCCE) abnormalities are not well defined. METHODS:Observational study of patients with ARDS, admitted f...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0343-9
更新日期:2017-12-19 00:00:00
abstract:BACKGROUND:Mortality of critically ill hematology (HM) patients has improved over time. Thus, those patients require an extensive diagnostic workup and the optimal use of available treatments. There are no data regarding nutrition strategy for critically ill HM patients, while nutritional support is crucial for both HM...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0527-6
更新日期:2019-05-07 00:00:00
abstract:BACKGROUND:Intravenous crystalloid solutions are administered commonly for critically ill patients. We performed this meta-analysis of randomized trials with trial sequential analysis (TSA) to evaluate effects of chloride content of intravenous crystalloid solutions on clinical outcomes among critically ill adult patie...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0506-y
更新日期:2019-02-13 00:00:00
abstract:BACKGROUND:Glucose control is an important issue in post-operative patients. The objective here was to compare two insulin infusion lines by syringe pumps to assess the impact of medical devices on glycaemic variability in surgical patients under intensive insulin therapy. This open, prospective, single-centre randomis...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0298-x
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Sepsis is a common condition that has a high mortality and morbidity that need prompt diagnosis and treatment. Biomarkers like Soluble CD14 subtype (sCD14-ST, presepsin) may be useful in identifying patients with sepsis and its diagnostic superiority has been confirmed by several preliminary studies. The aim...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-015-0089-1
更新日期:2015-12-01 00:00:00
abstract:: Erythropoietin (EPO) is the major hormone stimulating the production and differentiation of red blood cells. EPO is used widely for treating anemia of critical illness or anemia induced by chemotherapy. EPO at pharmacological doses is used in this setting to raise hemoglobin levels (by preventing the apoptosis of ery...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-1-40
更新日期:2011-09-23 00:00:00
abstract::Anemia and red blood cell (RBC) transfusion occur frequently in hospitalized patients with cardiac disease. In this narrative review, we report the epidemiology of anemia and RBC transfusion in hospitalized adults and children (excluding premature neonates) with cardiac disease, and on the outcome of anemic and transf...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/2110-5820-4-16
更新日期:2014-06-02 00:00:00