{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T04:26:23Z","timestamp":1774326383635,"version":"3.50.1"},"reference-count":60,"publisher":"Akademiai Kiado Zrt.","issue":"3","license":[{"start":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T00:00:00Z","timestamp":1693872000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["PhysInt"],"published-print":{"date-parts":[[2023,9,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acute and chronic hepatic failure can lead to increased mortality in critically ill and perioperative patients. Understanding the pathophysiological principles of these conditions in critically ill patients is of great importance to reduce mortality. The aim of our systematic literature review was to identify all randomized controlled trials on any intervention that had a statistically significant documented reduction in mortality in patients with hepatic failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched PubMed, Scopus and Embase databases for pertinent studies on January 1st 2021. The following studies were included: randomized controlled trials; studies investigating adult critically ill or perioperative patient populations with any form of hepatic failure; mortality as primary or secondary outcome; and statistically significant differences in mortality between the examined groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We finally found nine trials in our systematic review on the effect of antibiotic administration and infectious diseases among patients with cirrhosis (three studies); immune modulation after liver transplantation (one study); administration of colloids in cirrhotic patients (one study); the effect of high-volume plasma exchange in acute liver failure (one study); administration of N-acetylcysteine in acute liver failure (one study); and treatment with terlipressin (two studies).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the present review we found only nine randomized studies with a documented survival benefit in patients with liver failure. Strategies that most improved mortality were associated with the outcome of sepsis and renal function.<\/jats:p><\/jats:sec>","DOI":"10.1556\/2060.2023.00211","type":"journal-article","created":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T08:54:18Z","timestamp":1693212858000},"page":"211-226","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":1,"title":["Factors improving mortality in critically ill patients with liver failure \u2013 A systematic review"],"prefix":"10.1556","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2012-1136","authenticated-orcid":true,"given":"Enik\u0151","family":"Kov\u00e1cs","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, Semmelweis University, Budapest, H-1428, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicol\u00f2","family":"Maimeri","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Orlando","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Morselli","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ottavia","family":"Pallanch","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Fedrizzi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00e1nos","family":"G\u00e1l","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, Semmelweis University, Budapest, H-1428, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Sz\u00e9kely","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, Semmelweis University, Budapest, H-1428, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"issue":"9736","key":"B1","series-title":"Lancet","first-page":"190","article-title":"Acute liver failure","volume":"376","author":"Bernal W","year":"2010","unstructured":"Bernal W, Auzinger G, Dhawan A, Wendon J. Acute liver failure. Lancet 2010; 376(9736): 190\u2013201. https:\/\/doi.org\/10.1016\/S0140-6736(10)60274-7."},{"issue":"11","key":"B2","series-title":"Am J Gastroenterol","first-page":"2459","article-title":"Population-based surveillance for acute liver failure","volume":"102","author":"Bower WA","year":"2007","unstructured":"Bower WA, Johns M, Margolis HS, Williams IT, Bell BP. Population-based surveillance for acute liver failure. Am J Gastroenterol 2007; 102(11): 2459\u20132463. https:\/\/doi.org\/10.1111\/j.1572-0241.2007.01388.x."},{"issue":"11","key":"B3","series-title":"QJM","first-page":"945","article-title":"Acute liver failure in Scotland between 1992 and 2009; incidence, aetiology and outcome","volume":"104","author":"Bretherick AD","year":"2011","unstructured":"Bretherick AD, Craig DG, Masterton G, Bates C, Davidson J, Martin K, et\u00a0al. Acute liver failure in Scotland between 1992 and 2009; incidence, aetiology and outcome. 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Liver Int 2019; 39(7): 1271\u20131280. https:\/\/doi.org\/10.1111\/liv.14083."},{"issue":"3","key":"B12","series-title":"Crit Care Med","first-page":"e173","article-title":"Guidelines for the management of adult acute and acute-on-chronic liver failure in the ICU: cardiovascular, endocrine, hematologic, pulmonary, and renal considerations","volume":"48","author":"Nanchal R","year":"2020","unstructured":"Nanchal R, Subramanian R, Karvellas CJ, Hollenberg SM, Peppard WJ, Singbartl K, et\u00a0al. Guidelines for the management of adult acute and acute-on-chronic liver failure in the ICU: cardiovascular, endocrine, hematologic, pulmonary, and renal considerations. 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