{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:34:45Z","timestamp":1791520485643,"version":"4.3.4"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T00:00:00Z","timestamp":1568937600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T00:00:00Z","timestamp":1568937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hepatol Int"],"published-print":{"date-parts":[[2019,11]]},"DOI":"10.1007\/s12072-019-09986-9","type":"journal-article","created":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T06:34:02Z","timestamp":1568961242000},"page":"800-813","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Treatment with carvedilol improves survival of patients with acute-on-chronic liver failure: a randomized controlled trial"],"prefix":"10.1007","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3448-8334","authenticated-orcid":false,"given":"Manoj","family":"Kumar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumit","family":"Kainth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok","family":"Choudhury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakhi","family":"Maiwall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lalita G.","family":"Mitra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vandana","family":"Saluja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashant Mohan","family":"Agarwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saggere Muralikrishna","family":"Shasthry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankur","family":"Jindal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankit","family":"Bhardwaj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guresh","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiv K.","family":"Sarin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,9,20]]},"reference":[{"key":"9986_CR1","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1016\/S0140-6736(81)91617-2","volume":"1","author":"D Lebrec","year":"1981","unstructured":"Lebrec D, Nouel O, Bernuau J, Bouygues M, Rueff B, Benhamou JP. Propranolol in prevention of recurrent gastrointestinal bleeding in cirrhotic patients. Lancet. 1981;1:920\u20131.","journal-title":"Lancet"},{"key":"9986_CR2","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1186\/cc8026","volume":"13","author":"E de Montmollin","year":"2009","unstructured":"de Montmollin E, Aboab J, Mansart A, Annane D. Bench-to-bedside review: betaadrenergic modulation in sepsis. Crit Care. 2009;13:230.","journal-title":"Crit Care"},{"key":"9986_CR3","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1002\/hep.510310109","volume":"31","author":"M Perez-Paramo","year":"2000","unstructured":"Perez-Paramo M, Munoz J, Albillos A, Freile I, Portero F, Santos M, et al. Effect of propranolol on the factors promoting bacterial translocation in cirrhotic rats with ascites. Hepatology. 2000;31:43\u20138.","journal-title":"Hepatology"},{"key":"9986_CR4","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1016\/j.jhep.2012.12.011","volume":"58","author":"T Reiberger","year":"2013","unstructured":"Reiberger T, Ferlitsch A, Payer BA, Mandorfer M, Heinisch BB, Hayden H, et al. Non-selective betablocker therapy decreases intestinal permeability and serum levels of LBP and IL-6 in patients with cirrhosis. J Hepatol. 2013;58:911\u201321.","journal-title":"J Hepatol"},{"key":"9986_CR5","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1053\/jhep.2003.50133","volume":"37","author":"JG Abraldes","year":"2003","unstructured":"Abraldes JG, Tarantino I, Turnes J, Garcia-Pagan JC, Rodes J, Bosch J. Hemodynamic response to pharmacological treatment of portal hypertension and long-term prognosis of cirrhosis. Hepatology. 2003;37:902\u20138.","journal-title":"Hepatology"},{"key":"9986_CR6","doi-asserted-by":"publisher","first-page":"1611","DOI":"10.1053\/j.gastro.2006.09.013","volume":"131","author":"G D\u2019Amico","year":"2006","unstructured":"D\u2019Amico G, Garcia-Pagan JC, Luca A, Bosch J. HVPG reduction and prevention of variceal bleeding in cirrhosis. A systematic review. Gastroenterology. 2006;131:1611\u201324.","journal-title":"Gastroenterology"},{"key":"9986_CR7","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1111\/j.1478-3231.2009.02038.x","volume":"29","author":"M Senzolo","year":"2009","unstructured":"Senzolo M, Cholongitas E, Burra P, Leandro G, Thalheimer U, Patch D, et al. Beta-blockers protect against spontaneous bacterial peritonitis in cirrhotic patients: a meta-analysis. Liver Int. 2009;29:1189\u201393.","journal-title":"Liver Int"},{"key":"9986_CR8","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1007\/s10620-008-0421-9","volume":"54","author":"A Kumar","year":"2009","unstructured":"Kumar A, Das K, Sharma P, Mehta V, Sharma BC, Sarin SK. Hepatic venous pressure gradient, systemic and pulmonary hemodynamics in patients with acute-on-chronic liver failure. Dig Dis Sci. 2009;54:869\u201378.","journal-title":"Dig Dis Sci"},{"issue":"8","key":"9986_CR9","doi-asserted-by":"publisher","first-page":"1361","DOI":"10.1111\/jgh.12191","volume":"28","author":"H Garg","year":"2013","unstructured":"Garg H, Kumar A, Garg V, Kumar M, Kumar R, Sharma BC, et al. Hepatic and systemic hemodynamic derangements predict early mortality and recovery in patients with acute-on-chronic liver failure. J Gastroenterol Hepatol. 2013;28(8):1361\u20137.","journal-title":"J Gastroenterol Hepatol"},{"issue":"2","key":"9986_CR10","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1097\/MCC.0b013e328344a076","volume":"17","author":"RP Mookerjee","year":"2011","unstructured":"Mookerjee RP. Acute-on-chronic liver failure: liver and portal haemodynamics. Curr Opin Crit Care. 2011;17(2):170\u20136.","journal-title":"Curr Opin Crit Care."},{"key":"9986_CR11","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1016\/j.jhep.2015.10.018","volume":"64","author":"RP Mookerjee","year":"2016","unstructured":"Mookerjee RP, Pavesi M, Thomsen KL, Mehta G, Macnaughtan J, Bendtsen F, et al. Treatment with non-selective beta-blockers is associated with reduced severity of systemic inflammation and improved survival of patients with acute-on-chronic liver failure. J Hepatol. 2016;64:574\u201382.","journal-title":"J Hepatol"},{"issue":"4","key":"9986_CR12","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1007\/s12072-014-9580-2","volume":"8","author":"SK Sarin","year":"2014","unstructured":"Sarin SK, Kedarisetty CK, Abbas Z, Amarapurkar D, Bihari C, Chan AC, et al. APASL ACLF Working Party. Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL) 2014. Hepatol Int. 2014;8(4):453\u201371.","journal-title":"Hepatol Int."},{"key":"9986_CR13","doi-asserted-by":"publisher","first-page":"1348","DOI":"10.1002\/hep.21607","volume":"45","author":"A Louvet","year":"2007","unstructured":"Louvet A, Naveau S, Abdelnour M, Ramond MJ, Diaz E, Fartoux L, et al. The Lille model: a new tool for therapeutic strategy in patients with severe alcoholic hepatitis treated with steroids. Hepatology. 2007;45:1348\u201354.","journal-title":"Hepatology"},{"issue":"5","key":"9986_CR14","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1007\/s12072-017-9816-z","volume":"11","author":"A Choudhury","year":"2017","unstructured":"Choudhury A, Jindal A, Maiwall R, Sharma MK, Sharma BC, Pamecha V, et al. Liver failure determines the outcome in patients of acute-on-chronic liver failure (ACLF): comparison of APASL ACLF research consortium (AARC) and CLIF-SOFA models. Hepatol Int. 2017;11(5):461\u201371.","journal-title":"Hepatol Int."},{"key":"9986_CR15","unstructured":"http:\/\/www.aclf.in\/?page=doctor_aarc_grade_cal\n\n."},{"key":"9986_CR16","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1016\/j.jhep.2014.06.012","volume":"61","author":"R Jalan","year":"2014","unstructured":"Jalan R, Saliba F, Pavesi M, Amoros A, Moreau R, Gin\u00e8s P, et al. Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure. J Hepatol. 2014;61:1038\u201347.","journal-title":"J Hepatol"},{"key":"9986_CR17","unstructured":"https:\/\/www.clifresearch.com\/ToolsCalculators.aspx\n\n."},{"key":"9986_CR18","doi-asserted-by":"publisher","first-page":"986-74","DOI":"10.1016\/j.jhep.2014.12.029","volume":"62","author":"P Angeli","year":"2015","unstructured":"Angeli P, Gines P, Wong F, et al. Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites. J Hepatol. 2015;62:986-74.","journal-title":"J Hepatol"},{"key":"9986_CR19","doi-asserted-by":"publisher","first-page":"S18","DOI":"10.1016\/j.jceh.2013.03.040","volume":"3","author":"A Jindal","year":"2013","unstructured":"Jindal A, Vashistha C, Sharma MK, Sarin SK. Acute-on-chronic liver failure- does etiology really matter? J Clin Exp Hepatol. 2013;3:S18\u201320.","journal-title":"J Clin Exp Hepatol."},{"issue":"3","key":"9986_CR20","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1038\/nrgastro.2015.219","volume":"13","author":"SK Sarin","year":"2016","unstructured":"Sarin SK, Choudhury A. Acute-on-chronic liver failure: terminology, mechanisms and management. Nat Rev Gastroenterol Hepatol. 2016;13(3):131\u20134.","journal-title":"Nat Rev Gastroenterol Hepatol."},{"key":"9986_CR21","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1111\/j.1572-0241.2006.00453.x","volume":"101","author":"J Turnes","year":"2006","unstructured":"Turnes J, Garcia-Pagan JC, Abraldes JG, Hernandez-Guerra M, Dell\u2019Era A, Bosch J, et al. Pharmacological reduction of portal pressure and long-term risk of first variceal bleeding in patients with cirrhosis. Am J Gastroenterol. 2006;101:506\u201312.","journal-title":"Am J Gastroenterol"},{"key":"9986_CR22","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/j.jhep.2005.05.009","volume":"43","author":"R De Franchis","year":"2005","unstructured":"De Franchis R. Evolving consensus in portal hypertension. Report of the Baveno IV consensus workshop on methodology of diagnosis and therapy in portal hypertension. J Hepatol. 2005;43:167\u201376.","journal-title":"J Hepatol"},{"key":"9986_CR23","doi-asserted-by":"publisher","first-page":"2436","DOI":"10.1111\/j.1572-0241.2006.00742_5.x","volume":"101","author":"M Senzolo","year":"2006","unstructured":"Senzolo M, Cholongitas E, Marelli L, Thalheimer U, Patch D, Burroughs AK, et al. The low incidence of bacterial infections could be a protective factor against variceal bleeding per se in hemodynamic responders to propranolol. Am J Gastroenterol. 2006;101:2436\u20137.","journal-title":"Am J Gastroenterol"},{"key":"9986_CR24","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1086\/432134","volume":"192","author":"RH Straub","year":"2005","unstructured":"Straub RH, Pongratz G, Weidler C, Linde HJ, Kirschning CJ, Gl\u00fcck T, et al. Ablation of the sympathetic nervous system decreases gram-negative and increases gram-positive bacterial dissemination: key roles for tumor necrosis factor\/phagocytes and interleukin-4\/lymphocytes. J Infect Dis. 2005;192:560\u201372.","journal-title":"J Infect Dis"},{"key":"9986_CR25","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1136\/gut.2009.185413","volume":"59","author":"M Worlicek","year":"2010","unstructured":"Worlicek M, Knebel K, Linde HJ, Moleda L, Sch\u00f6lmerich J, Straub RH, et al. Splanchnic sympathectomy prevents translocation and spreading of E. coli but not S. aureus in liver cirrhosis. Gut. 2010;59:1127\u201334.","journal-title":"Gut."},{"key":"9986_CR26","first-page":"595","volume":"52","author":"IJ Elenkov","year":"2000","unstructured":"Elenkov IJ, Wilder RL, Chrousos GP, Vizi ES. The sympathetic nerve\u2013an integrative interface between two supersystems: the brain and the immune system. Pharmacol Rev. 2000;52:595\u2013638.","journal-title":"Pharmacol Rev"},{"key":"9986_CR27","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1016\/j.mehy.2004.06.030","volume":"64","author":"KE Peuschel","year":"2005","unstructured":"Peuschel KE. Antiviral therapy with non-selective beta blockers: preliminary experimental and clinical corroboration. Med Hypotheses. 2005;64:256\u201360.","journal-title":"Med Hypotheses"},{"key":"9986_CR28","doi-asserted-by":"publisher","first-page":"1683","DOI":"10.1001\/jama.2013.278477","volume":"310","author":"A Morelli","year":"2013","unstructured":"Morelli A, Ertmer C, Westphal M, Rehberg S, Kampmeier T, Ligges S, et al. Effect of heart rate control with esmolol on hemodynamic and clinical outcomes in patients with septic shock: a randomized clinical trial. JAMA. 2013;310:1683\u201391.","journal-title":"JAMA"},{"key":"9986_CR29","doi-asserted-by":"publisher","first-page":"1974","DOI":"10.1111\/liv.12786","volume":"35","author":"T Serst\u00e9","year":"2015","unstructured":"Serst\u00e9 T, Njimi H, Degr\u00e9 D, Deltenre P, Schreiber J, Lepida A, et al. The use of beta-blockers is associated with the occurrence of acute kidney injury in severe alcoholic hepatitis. Liver Int. 2015;35:1974\u201382.","journal-title":"Liver Int"},{"key":"9986_CR30","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1007\/s00134-008-1253-y","volume":"35","author":"A Umgelter","year":"2009","unstructured":"Umgelter A, Reindl W, Franzen M, Lenhardt C, Huber W, Schmid RM. Renal resistive index and renal function before and after paracentesis in patients with hepatorenal syndrome and tense ascites. Intensive Care Med. 2009;35:152\u20136.","journal-title":"Intensive Care Med"},{"issue":"4","key":"9986_CR31","doi-asserted-by":"publisher","first-page":"206","DOI":"10.15171\/mejdd.2017.75","volume":"9","author":"KA Rezayat","year":"2017","unstructured":"Rezayat KA, Zeraati AA, Pezeshki Rad M, Chogan J, Davoudian N, Akhavan Rezayat A, et al. Impact of propranolol on preventing renal dysfunction in patients with cirrhosis. Middle East J Dig Dis. 2017;9(4):206\u201311.","journal-title":"Middle East J Dig Dis."},{"key":"9986_CR32","first-page":"1408","volume":"51","author":"S Kastelan","year":"2004","unstructured":"Kastelan S, Ljubicic N, Kastelan Z, Ostojic R, Uravic M. The role of duplex-doppler ultrasonography in the diagnosis of renal dysfunction and hepatorenal syndrome in patients with liver cirrhosis. Hepatogastroenterology. 2004;51:1408\u201312.","journal-title":"Hepatogastroenterology"},{"key":"9986_CR33","first-page":"230","volume":"10","author":"H Ozcan","year":"2004","unstructured":"Ozcan H, Aytac SK, Yagmurlu B, Erten A. Effect of propranolol on renal hemodynamics in patients with cirrhosis: assessment with Doppler US. Tani Girisim Radyol. 2004;10:230\u20133.","journal-title":"Tani Girisim Radyol"},{"issue":"4","key":"9986_CR34","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/j.jceh.2017.09.003","volume":"7","author":"A Kumar","year":"2017","unstructured":"Kumar A, Sharma P, Anikhindi SA, Prajapati R, Agarwal R, Sharma B, Bansal N, Singla V, Arora A. Can non-selective beta-blockers (NSBBs) prevent enlargement of small esophageal varices in patients with cirrhosis? A Meta-analysis. J Clin Exp Hepatol. 2017;7(4):275\u201383.","journal-title":"J Clin Exp Hepatol."}],"container-title":["Hepatology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s12072-019-09986-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s12072-019-09986-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s12072-019-09986-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T23:31:30Z","timestamp":1600471890000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s12072-019-09986-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,20]]},"references-count":34,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,11]]}},"alternative-id":["9986"],"URL":"https:\/\/doi.org\/10.1007\/s12072-019-09986-9","relation":{},"ISSN":["1936-0533","1936-0541"],"issn-type":[{"value":"1936-0533","type":"print"},{"value":"1936-0541","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,20]]},"assertion":[{"value":"16 June 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 August 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 September 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study has been approved by the institutional ethics committee of the Institute of Liver and Biliary Sciences (Letter no. F.25\/5\/80\/ILBS\/AC\/2015\/711) and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}