Executive Summary: Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-Transplant Medicine, Infectious Disease, and Gastroenterology Considerations

doi:10.1097/CCM.0000000000005825

. 2023 May 1;51(5):653-656.

doi: 10.1097/CCM.0000000000005825. Epub 2023 Apr 13.

Executive Summary: Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-Transplant Medicine, Infectious Disease, and Gastroenterology Considerations

Rahul Nanchal¹, Ram Subramanian², Waleed Alhazzani³, Joanna C Dionne³, William J Peppard⁴, Kai Singbartl⁵, Jonathon Truwit⁶, Ali H Al-Khafaji⁷, Alley J Killian², Mustafa Alquraini⁸, Khalil Alshammari⁸, Fayez Alshamsi⁸, Emilie Belley-Cote³, Rodrigo Cartin-Ceba⁹, Steven M Hollenberg¹⁰, Dragos M Galusca¹¹, David T Huang⁷, Robert C Hyzy¹², Mats Junek³, Prem Kandiah², Gagan Kumar¹³, Rebecca L Morgan¹⁴, Peter E Morris¹⁵, Jody C Olson¹⁶, Rita Sieracki⁶, Randolph Steadman¹⁷, Beth Taylor¹⁸, Constantine J Karvellas¹⁹

Affiliations

¹ Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI.
² Emory University Hospital, Atlanta, GA.
³ Department of Medicine, McMaster University, Hamilton, ON, Canada.
⁴ Froedtert and the Medical College of Wisconsin, Milwaukee, WI.
⁵ Mayo Clinic, Phoenix, AZ.
⁶ Medical College of Wisconsin, Milwaukee, WI.
⁷ University of Pittsburgh Medical Center, Pittsburgh, PA.
⁸ GUIDE Group, McMaster University, Hamilton, ON, Canada.
⁹ Mayo Clinic, Rochester, MN.
¹⁰ Hackensack University Medical Center, Hackensack, NJ.
¹¹ Henry Ford Health System, Detroit, MI.
¹² University of Michigan Hospitals, Ann Arbor, MI.
¹³ Northeast Georgia Medical Center, Gainesville, GA.
¹⁴ Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
¹⁵ University of Kentucky College of Medicine, Lexington, KY.
¹⁶ Kansas University Medical Center, Kansas City, KS.
¹⁷ University of California Los Angeles Medical Center, Los Angeles, CA.
¹⁸ Barnes Jewish Hospital, St. Louis, MO.
¹⁹ Department of Critical Care Medicine and Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, AB, Canada.

PMID: 37052435
DOI: 10.1097/CCM.0000000000005825

Executive Summary: Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-Transplant Medicine, Infectious Disease, and Gastroenterology Considerations

Rahul Nanchal et al. Crit Care Med. 2023.

. 2023 May 1;51(5):653-656.

doi: 10.1097/CCM.0000000000005825. Epub 2023 Apr 13.

Authors

Affiliations

¹ Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI.
² Emory University Hospital, Atlanta, GA.
³ Department of Medicine, McMaster University, Hamilton, ON, Canada.
⁴ Froedtert and the Medical College of Wisconsin, Milwaukee, WI.
⁵ Mayo Clinic, Phoenix, AZ.
⁶ Medical College of Wisconsin, Milwaukee, WI.
⁷ University of Pittsburgh Medical Center, Pittsburgh, PA.
⁸ GUIDE Group, McMaster University, Hamilton, ON, Canada.
⁹ Mayo Clinic, Rochester, MN.
¹⁰ Hackensack University Medical Center, Hackensack, NJ.
¹¹ Henry Ford Health System, Detroit, MI.
¹² University of Michigan Hospitals, Ann Arbor, MI.
¹³ Northeast Georgia Medical Center, Gainesville, GA.
¹⁴ Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
¹⁵ University of Kentucky College of Medicine, Lexington, KY.
¹⁶ Kansas University Medical Center, Kansas City, KS.
¹⁷ University of California Los Angeles Medical Center, Los Angeles, CA.
¹⁸ Barnes Jewish Hospital, St. Louis, MO.
¹⁹ Department of Critical Care Medicine and Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, AB, Canada.

PMID: 37052435
DOI: 10.1097/CCM.0000000000005825

No abstract available

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Conflict of interest statement

Conflicts of interest were reviewed and adjudicated by the co-chairs and co-vice chairs of the guidelines. In the event an individual disclosed a conflict or potential conflict by submitted form or verbally during the process of guidelines, those individuals abstained from voting on related questions. The taskforce followed all procedures as documented in the American College of Critical Care Medicine/Society of Critical Care Medicine (SCCM) Standard Operating Procedures Manual. Drs. Singbartl, Nanchal, Killian, Olson, Karvellas, Subramanian, and Truwit disclosed authorship on several related articles with potential intellectual conflicts explored and adjudicated. Dr. Dionne described volunteer service for Canadian Association of Gastroenterology, American College of Gastroenterology, American Gastroenterological Association, and European Society of Intensive Care Medicine. Dr. Hyzy described volunteer service for American Thoracic Society, Quality Improvement and Implementation Committee, and the SCCM Finance Committee as well as service as an expert witness in a previous medical case involving this subject matter. Taylor advised of service as an author on the SCCM/American Society for Parenteral and Enteral Nutrition (ASPEN) nutrition guidelines and service on the ASPEN research committee. Dr. Huang disclosed service on the American College of Emergency Physicians sepsis task force. Dr. Karvellas disclosed service on an acute liver failure study group. Dr. Hyzy and Dr. Olson disclosed being expert witnesses. The remaining authors have disclosed that they do not have any potential conflicts of interest.

References

1. Nanchal R, Subramanian R, Karvellas CJ, et al.: Guidelines for the management of adult acute and acute-on-chronic liver failure in the ICU: Cardiovascular, endocrine, hematologic, pulmonary, and renal considerations. Crit Care Med 2020; 48:e173–e191
1. GRADEpro GDT: GRADEpro Guideline Development Tool [Software]. 2015. Available at: gradepro.org . Accessed August 8, 2021
1. Chavez-Tapia NC, Barrientos-Gutierrez T, Tellez-Avila F, et al.: Meta-analysis: Antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding - an updated Cochrane review. Aliment Pharmacol Ther 2011; 34:509–518
1. Salerno F, Navickis RJ, Wilkes MM: Albumin infusion improves outcomes of patients with spontaneous bacterial peritonitis: A meta-analysis of randomized trials. Clin Gastroenterol Hepatol 2013; 11:123–130.e1
1. Jalan R, Fernandez J, Wiest R, et al.: Bacterial infections in cirrhosis: A position statement based on the EASL Special Conference 2013. J Hepatol 2014; 60:1310–1324

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[1] Nanchal R, Subramanian R, Karvellas CJ, et al.: Guidelines for the management of adult acute and acute-on-chronic liver failure in the ICU: Cardiovascular, endocrine, hematologic, pulmonary, and renal considerations. Crit Care Med 2020; 48:e173–e191

[2] Nanchal R, Subramanian R, Karvellas CJ, et al.: Guidelines for the management of adult acute and acute-on-chronic liver failure in the ICU: Cardiovascular, endocrine, hematologic, pulmonary, and renal considerations. Crit Care Med 2020; 48:e173–e191

[3] GRADEpro GDT: GRADEpro Guideline Development Tool [Software]. 2015. Available at: gradepro.org . Accessed August 8, 2021

[4] GRADEpro GDT: GRADEpro Guideline Development Tool [Software]. 2015. Available at: gradepro.org . Accessed August 8, 2021

[5] Chavez-Tapia NC, Barrientos-Gutierrez T, Tellez-Avila F, et al.: Meta-analysis: Antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding - an updated Cochrane review. Aliment Pharmacol Ther 2011; 34:509–518

[6] Chavez-Tapia NC, Barrientos-Gutierrez T, Tellez-Avila F, et al.: Meta-analysis: Antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding - an updated Cochrane review. Aliment Pharmacol Ther 2011; 34:509–518

[7] Salerno F, Navickis RJ, Wilkes MM: Albumin infusion improves outcomes of patients with spontaneous bacterial peritonitis: A meta-analysis of randomized trials. Clin Gastroenterol Hepatol 2013; 11:123–130.e1

[8] Salerno F, Navickis RJ, Wilkes MM: Albumin infusion improves outcomes of patients with spontaneous bacterial peritonitis: A meta-analysis of randomized trials. Clin Gastroenterol Hepatol 2013; 11:123–130.e1

[9] Jalan R, Fernandez J, Wiest R, et al.: Bacterial infections in cirrhosis: A position statement based on the EASL Special Conference 2013. J Hepatol 2014; 60:1310–1324

[10] Jalan R, Fernandez J, Wiest R, et al.: Bacterial infections in cirrhosis: A position statement based on the EASL Special Conference 2013. J Hepatol 2014; 60:1310–1324

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Executive Summary: Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-Transplant Medicine, Infectious Disease, and Gastroenterology Considerations

Affiliations

Executive Summary: Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-Transplant Medicine, Infectious Disease, and Gastroenterology Considerations

Authors

Affiliations

Conflict of interest statement

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References

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LinkOut - more resources

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