Infection and the progression of hepatic encephalopathy in acute liver failure.

@article{Vaquero2003InfectionAT,
  title={Infection and the progression of hepatic encephalopathy in acute liver failure.},
  author={J. Vaquero and J. Polson and C. Chung and I. Helenowski and F. V. Schi{\o}dt and J. Reisch and William M. Lee and A. Blei},
  journal={Gastroenterology},
  year={2003},
  volume={125 3},
  pages={
          755-64
        }
}
BACKGROUND & AIMS Progression of hepatic encephalopathy (HE) is a major determinant of outcome in acute liver failure (ALF). Our aim was to identify predictive factors of worsening HE, including the relation of encephalopathy with the systemic inflammatory response (SIRS) and infection. METHODS We included 227 consecutive patients with stage I-II HE prospectively enrolled in the U.S. Acute Liver Failure Study. Univariate and multivariate analysis of 27 variables at admission were performed… Expand

Paper Mentions

Observational Clinical Trial
The purpose of this study is to collect clinical and epidemiological data as well as serum, plasma, urine, tissue and DNA samples on individuals who have acute liver failure and on… Expand
ConditionsAcute Liver Failure, Acute Liver Injury, Fulminant Hepatic Failure
Infection and systemic inflammation, not ammonia, are associated with Grade 3/4 hepatic encephalopathy, but not mortality in cirrhosis.
TLDR
Data support an association between infection/SIRS and not ammonia, in patients with cirrhosis that develop severe HE and the presence or absence of infection or SIRS did not determine survival. Expand
Arterial ammonia and clinical risk factors for encephalopathy and intracranial hypertension in acute liver failure
TLDR
Ammonia is an independent risk factor for the development of both HE and ICH, and its combination with ammonia increased specificity and accuracy and improved the prediction of HE. Expand
Predictors of infection in viral-hepatitis related acute liver failure
TLDR
Cerebral edema, elevated ammonia on day 3, and higher MELD score predict the development of infection in ALF, and elevated ammonia in patients with and without infection is associated with complications and death. Expand
Prognostic implications of lactate, bilirubin, and etiology in German patients with acute liver failure.
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  • Medicine
  • Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
  • 2008
TLDR
The simple, combined BiLE score emerged as the best predictor of poor outcome in the authors' patient cohort and should be prospectively evaluated in other populations. Expand
SIRS score reflects clinical features of non-acetaminophen-related acute liver failure with hepatic coma.
TLDR
SIRS score will be useful for predicting not only the overall survival but also the development of complications such as ARDS, DIC and MOF in non-acetaminophen-related ALF with hepatic coma. Expand
Liver Failure: Acute and Acute on Chronic
Acute liver failure (ALF) is defined as the development of hepatic encephalopathy (HE) and coagulopathy in a patient with no history of previous liver disease, with the onset HE within 26 weeks ofExpand
The systemic inflammatory response syndrome in cirrhotic patients: relationship with their in-hospital outcome.
TLDR
SIRS frequently occurs in patients with advanced cirrhosis and is associated with a poor outcome and on multivariate analysis, SIRS and MELD were independently associated with death. Expand
The systemic inflammatory response syndrome is predictive of renal dysfunction in patients with non-paracetamol-induced acute liver failure
TLDR
SIRS is strongly associated with the development of renal dysfunction in patients with non-paracetamol-induced ALF, and it is proposed that the systemic inflammatory cascade plays a key role in its pathogenesis. Expand
A study on the position and etiology of infection in cirrhotic patients: A potential precipitating factor contributing to hepatic encephalopathy
TLDR
Respiratory tract infection was identified to be the most common precipitating factor for HE, and Pneumococci and E. coli were common bacteria that induced infection in the respiratory tract and at other infection sites, respectively. Expand
Severity of organ failure is an independent predictor of intracranial hypertension in acute liver failure.
  • R. Kitzberger, G. Funk, +5 authors C. Madl
  • Medicine
  • Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
  • 2009
TLDR
In patients with acute liver failure admitted to the intensive care unit, pNH(3) level is a better predictor of clinical grade of hepatic encephalopathy than arterial NH(2) level, and SOFA score and ammonia levels are independent predictors of intracranial hypertension. Expand
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