Outcomes of critically ill patients with liver failure who require mechanical ventilation: A retrospective, single‐center study
Abstract Background and Aims Critically ill patients with liver failure have high mortality. Besides the management of organ‐specific complications, liver transplantation constitutes a definitive treatment. However, clinicians may hesitate to introduce mechanical ventilation for patients on liver tr...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-03-01
|
| Series: | Health Science Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/hsr2.1926 |
| _version_ | 1797237013363032064 |
|---|---|
| author | Atsuyoshi Mita Sari Shimizu Takashi Ichiyama Takateru Yamamoto Akinori Yamaguchi Kosuke Sonoda Kotaro Mori Tomokatsu Yamada Hiroyuki Nakamura Hiroshi Imamura |
| author_facet | Atsuyoshi Mita Sari Shimizu Takashi Ichiyama Takateru Yamamoto Akinori Yamaguchi Kosuke Sonoda Kotaro Mori Tomokatsu Yamada Hiroyuki Nakamura Hiroshi Imamura |
| author_sort | Atsuyoshi Mita |
| collection | DOAJ |
| description | Abstract Background and Aims Critically ill patients with liver failure have high mortality. Besides the management of organ‐specific complications, liver transplantation constitutes a definitive treatment. However, clinicians may hesitate to introduce mechanical ventilation for patients on liver transplantation waitlists because of poor prognosis. This study investigated the outcomes of intensive care and ventilation support therapy effects in patients with liver failure. Methods This single‐center study retrospectively enrolled 32 consecutive patients with liver failure who were admitted to the intensive care unit from January 2014 to December 2020. The medical records were reviewed and analyzed retrospectively for Acute Physiologic and Chronic Health Evaluation (APACHE)‐II. The model for end‐stage liver disease scores, 90‐day mortality, and survival was assessed using the Kaplan–Meier method. Results The average patient age was 45.5 ± 20.1 years, and 53% of patients were women. On intensive care unit admission, APACHE‐II and model for end‐stage liver disease scores were 20 and 28, respectively. Among 13 patients considered for liver transplantation, 4 received transplants. Thirteen patients (40.6%) were intubated and mechanically ventilated in the intensive care unit. The 90‐day mortality rate of patients with and without mechanical ventilation in the intensive care unit (13, 61.5% vs. 19, 47.4%, p = 0.4905) was similar. APACHE‐II score >21 was an independent predictor of mechanical ventilation requirement in patients with liver failure during intensive care unit stay. Conclusion Although critically ill patients with liver failure are at risk of multiorgan failure with poor outcomes, mechanical ventilation did not negatively affect the 90‐day mortality or performance rates of liver transplantation. Clinicians should consider mechanical ventilation‐based life support in critically ill patients with liver failure who are awaiting liver transplantation. |
| first_indexed | 2024-04-24T17:13:00Z |
| format | Article |
| id | doaj.art-9e47213ccde843d3ade5dad77044e8fd |
| institution | Directory Open Access Journal |
| issn | 2398-8835 |
| language | English |
| last_indexed | 2024-04-24T17:13:00Z |
| publishDate | 2024-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Science Reports |
| spelling | doaj.art-9e47213ccde843d3ade5dad77044e8fd2024-03-28T08:36:41ZengWileyHealth Science Reports2398-88352024-03-0173n/an/a10.1002/hsr2.1926Outcomes of critically ill patients with liver failure who require mechanical ventilation: A retrospective, single‐center studyAtsuyoshi Mita0Sari Shimizu1Takashi Ichiyama2Takateru Yamamoto3Akinori Yamaguchi4Kosuke Sonoda5Kotaro Mori6Tomokatsu Yamada7Hiroyuki Nakamura8Hiroshi Imamura9Intensive Care Unit, Shinshu University Hospital Shinshu University School of Medicine Matsumoto JapanIntensive Care Unit, Shinshu University Hospital Shinshu University School of Medicine Matsumoto JapanIntensive Care Unit, Shinshu University Hospital Shinshu University School of Medicine Matsumoto JapanIntensive Care Unit, Shinshu University Hospital Shinshu University School of Medicine Matsumoto JapanIntensive Care Unit, Shinshu University Hospital Shinshu University School of Medicine Matsumoto JapanIntensive Care Unit, Shinshu University Hospital Shinshu University School of Medicine Matsumoto JapanIntensive Care Unit, Shinshu University Hospital Shinshu University School of Medicine Matsumoto JapanIntensive Care Unit, Shinshu University Hospital Shinshu University School of Medicine Matsumoto JapanIntensive Care Unit, Shinshu University Hospital Shinshu University School of Medicine Matsumoto JapanIntensive Care Unit, Shinshu University Hospital Shinshu University School of Medicine Matsumoto JapanAbstract Background and Aims Critically ill patients with liver failure have high mortality. Besides the management of organ‐specific complications, liver transplantation constitutes a definitive treatment. However, clinicians may hesitate to introduce mechanical ventilation for patients on liver transplantation waitlists because of poor prognosis. This study investigated the outcomes of intensive care and ventilation support therapy effects in patients with liver failure. Methods This single‐center study retrospectively enrolled 32 consecutive patients with liver failure who were admitted to the intensive care unit from January 2014 to December 2020. The medical records were reviewed and analyzed retrospectively for Acute Physiologic and Chronic Health Evaluation (APACHE)‐II. The model for end‐stage liver disease scores, 90‐day mortality, and survival was assessed using the Kaplan–Meier method. Results The average patient age was 45.5 ± 20.1 years, and 53% of patients were women. On intensive care unit admission, APACHE‐II and model for end‐stage liver disease scores were 20 and 28, respectively. Among 13 patients considered for liver transplantation, 4 received transplants. Thirteen patients (40.6%) were intubated and mechanically ventilated in the intensive care unit. The 90‐day mortality rate of patients with and without mechanical ventilation in the intensive care unit (13, 61.5% vs. 19, 47.4%, p = 0.4905) was similar. APACHE‐II score >21 was an independent predictor of mechanical ventilation requirement in patients with liver failure during intensive care unit stay. Conclusion Although critically ill patients with liver failure are at risk of multiorgan failure with poor outcomes, mechanical ventilation did not negatively affect the 90‐day mortality or performance rates of liver transplantation. Clinicians should consider mechanical ventilation‐based life support in critically ill patients with liver failure who are awaiting liver transplantation.https://doi.org/10.1002/hsr2.1926liver transplantationliver failureliver cirrhosismechanical ventilationrespiratory supportintensive care |
| spellingShingle | Atsuyoshi Mita Sari Shimizu Takashi Ichiyama Takateru Yamamoto Akinori Yamaguchi Kosuke Sonoda Kotaro Mori Tomokatsu Yamada Hiroyuki Nakamura Hiroshi Imamura Outcomes of critically ill patients with liver failure who require mechanical ventilation: A retrospective, single‐center study Health Science Reports liver transplantation liver failure liver cirrhosis mechanical ventilation respiratory support intensive care |
| title | Outcomes of critically ill patients with liver failure who require mechanical ventilation: A retrospective, single‐center study |
| title_full | Outcomes of critically ill patients with liver failure who require mechanical ventilation: A retrospective, single‐center study |
| title_fullStr | Outcomes of critically ill patients with liver failure who require mechanical ventilation: A retrospective, single‐center study |
| title_full_unstemmed | Outcomes of critically ill patients with liver failure who require mechanical ventilation: A retrospective, single‐center study |
| title_short | Outcomes of critically ill patients with liver failure who require mechanical ventilation: A retrospective, single‐center study |
| title_sort | outcomes of critically ill patients with liver failure who require mechanical ventilation a retrospective single center study |
| topic | liver transplantation liver failure liver cirrhosis mechanical ventilation respiratory support intensive care |
| url | https://doi.org/10.1002/hsr2.1926 |
| work_keys_str_mv | AT atsuyoshimita outcomesofcriticallyillpatientswithliverfailurewhorequiremechanicalventilationaretrospectivesinglecenterstudy AT sarishimizu outcomesofcriticallyillpatientswithliverfailurewhorequiremechanicalventilationaretrospectivesinglecenterstudy AT takashiichiyama outcomesofcriticallyillpatientswithliverfailurewhorequiremechanicalventilationaretrospectivesinglecenterstudy AT takateruyamamoto outcomesofcriticallyillpatientswithliverfailurewhorequiremechanicalventilationaretrospectivesinglecenterstudy AT akinoriyamaguchi outcomesofcriticallyillpatientswithliverfailurewhorequiremechanicalventilationaretrospectivesinglecenterstudy AT kosukesonoda outcomesofcriticallyillpatientswithliverfailurewhorequiremechanicalventilationaretrospectivesinglecenterstudy AT kotaromori outcomesofcriticallyillpatientswithliverfailurewhorequiremechanicalventilationaretrospectivesinglecenterstudy AT tomokatsuyamada outcomesofcriticallyillpatientswithliverfailurewhorequiremechanicalventilationaretrospectivesinglecenterstudy AT hiroyukinakamura outcomesofcriticallyillpatientswithliverfailurewhorequiremechanicalventilationaretrospectivesinglecenterstudy AT hiroshiimamura outcomesofcriticallyillpatientswithliverfailurewhorequiremechanicalventilationaretrospectivesinglecenterstudy |