AI Article Synopsis
- * Multi-drug resistant infections are common due to prolonged ICU stays and various medical interventions, emphasizing the importance of strict infection control practices.
- * Diagnosis relies on blood cultures, supported by specific markers for identifying types of infections, with therapy tailored based on culture results from respiratory infections.
Article Abstract
Infections in acute liver failure (ALF) increase the associated morbidity and mortality, and often hamper the possibility of transplantation. Two-thirds of the infections in ALF are bacterial while one-third is fungal. High suspicion for infection is essential whenever there is clinical deterioration. Multi-drug resistant infections are frequently encountered with prolonged ICU stay, invasive lines, ventilation and renal replacement therapy. Since most of the infections in ALF are nosocomial, prevention of infections is crucial by infection control practices in the ICU. Although markers such as CRP, procalcitonin (for bacterial infections), 1,3-beta-D glucan, and galactomannan (fungal infections) aid in the diagnosis, the gold standard is blood culture. Therapy for respiratory infections must be based on BAL or mini-BAL culture. In this article, we discuss the common infections occurring in ALF, methods for early diagnosis and recommended prophylactic, pre-emptive as well as therapeutic options for treating infections in ALF.
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| http://dx.doi.org/10.1016/j.bpg.2024.101958 | DOI Listing |
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Infections in acute liver failure - Assessment, prevention, and management.
Best Pract Res Clin Gastroenterol
December 2024
Department of Gastrointestinal Surgery and Solid Organ Transplant, Amrita Institute of Medical Sciences and Research Centre, Amrita University, Kochi, Kerala, India. Electronic address:
Article Synopsis
- * Multi-drug resistant infections are common due to prolonged ICU stays and various medical interventions, emphasizing the importance of strict infection control practices.
- * Diagnosis relies on blood cultures, supported by specific markers for identifying types of infections, with therapy tailored based on culture results from respiratory infections.
[Prognostic value of albumin and aspartate aminotransferase/alanine aminotransferase ratio in patients with acute liver failure in hyperacute phase of sepsis: a multicenter retrospective cohort study].
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
November 2024
Department of Gastroenterology, Shanghai Pudong New Area People's Hospital, Shanghai 201299, China. Corresponding author: Zhao Guangkuo, Email: Chang Yunli, Email:
Objective: To investigate the prognostic value of albumin (ALB), aspartate aminotransferase/alanine aminotransferase ratio (AST/ALT) in patients with acute liver failure (ALF) in hyperacute phase of sepsis which provided the basis for clinical evaluation and prognostic judgment and corresponding treatment options.
Methods: A multicenter retrospective cohort study was conducted. Patients with ALF in hyperacute phase of sepsis admitted to Zhoupu Hospital Affiliated to Shanghai Health College, Shanghai Pudong New Area People's Hospital, and Shanghai Oriental Hospital from January 2019 to February 2024 were enrolled.
Plasma lipidomics and fungal peptide-based community analysis identifies distinct signatures of early mortality in acute liver failure.
Clin Mol Hepatol
December 2024
Departments of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi.
Background And Aims: Acute liver failure (ALF) has high mortality predominantly due to compromised immune system and increase vulnerability to bacterial and fungal infections.
Method: Plasma lipidome and fungal peptide-based-community (mycobiome) analysis were performed in Discovery cohort (40-ALF, 5-healthy) and validated in a validation cohort of 230-ALF using High-resolution-mass-spectrometry, artificial-neural-network (ANN) and machine-learning (ML).
Results: Untargeted lipidomics identified 2,013 lipids across 8 lipid-groups.
Prognostic indicators and outcome in patients with acute liver failure, sepsis and with and without shock: a retrospective cohort study.
Ann Med
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Department of Critical Care Medicine, The Fifth Medical Center of PLA General Hospital, Beijing, China.
Background: Sepsis or septic shock is associated with severe morbidity and mortality in patients with acute liver failure (ALF). This study aimed to explore the potential prognostic value of common clinical indicators in patients with ALF, sepsis and with and without shock.
Patients And Methods: The clinical, laboratory, and microbiological data of patients with ALF and sepsis or septic shock who were admitted to the intensive care unit from January 2014 to December 2019 were collected retrospectively.
Validation of prognostic scores for predicting acute liver failure and in-hospital death in patients with dengue-induced severe hepatitis.
World J Gastroenterol
December 2024
Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand.
Article Synopsis
- Acute liver failure (ALF) in dengue patients is uncommon but highly fatal; identifying those at risk is crucial for improving survival rates.
- A study involving 2532 dengue patients revealed that factors like international normalized ratio, bilirubin, albumin, and creatinine can predict the likelihood of ALF and in-hospital mortality in patients with dengue-induced severe hepatitis (DISH).
- Several prognostic scores, including the MELD score and ALBI score, effectively predicted ALF and mortality, demonstrating high sensitivity and specificity in clinical assessments.
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