Index Note: Page numbers of article titles are in boldface type. A Accelerated intravascular coagulation and fibrinolysis (AICF) in liver disease, 390 391 Acid suppression in liver disease, 403 404 ACLF. See Acute-on-chronic liver failure (ACLF) Acute kidney injury (AKI) ALF and, 344 345 CLD and, 345 defined, 343 344 in liver disease causes of, 344 345 diagnosis of, 346 347 epidemiology of, 344 345 staging of, 346 347 Acute liver failure (ALF) AKI and, 344 345 B-ECLS in, 446 447 cerebral edema in, 313 CT in, 315 317 described, 440 ECLS systems in, 439 451 (See also Extracorporeal liver support (ECLS) systems, in ALF and ACLF) HE in, 313 intracranial hypertension in evaluation of serial laboratory testing in, 314 risk factors for, 314 invasive neuromonitoring in, 318 management of plasma ammonia lowering strategies in, 323 MARS and, 442 445 mortality related to, 313 MRI in, 318 neuroprotective strategies in, 320 noninvasive neuromonitoring in, 320 Acute-on-chronic liver failure (ACLF), 301 309 clinical studies of MARS and, 441 442 decompensated chronic liver failure vs., 305 306 defined, 301 described, 440 Crit Care Clin 32 (2016) 475 488 http://dx.doi.org/10.1016/s0749-0704(16)30045-8 0749-0704/16/$ see front matter criticalcare.theclinics.com
476 Index Acute-on-chronic (continued ) ECLS systems in, 439 451 (See also Extracorporeal liver support (ECLS) systems, in ALF and ACLF) infections in liver disease and, 416 Acute renal function in liver disease diagnosis and staging of, 346 347 Acute respiratory distress syndrome (ARDS) considerations in postoperative management of liver transplant patients, 460 Advanced liver disease, 303 307. See also Liver disease(s), advanced AEDs. See Antiepileptic drugs (AEDs) AICF. See Accelerated intravascular coagulation and fibrinolysis (AICF) AKI. See Acute kidney injury (AKI) Albumin in infections in liver disease management, 418 Albumin hypothesis detoxification and, 441 442 ALF. See Acute liver failure (ALF) Alternative pathway therapy Analgesics in liver disease, 402 Anion gap metabolic acidosis in liver disease, 349 Antiarrhythmics in liver disease, 403 Antibiotics ammonia-lowering in overt type C HE management in ICU, 324 in infections in liver disease management, 419 420 Anticoagulation in liver disease, 405 Antiemetics in liver disease, 404 Antiepileptic drugs (AEDs) in liver disease, 399 ARDS. See Acute respiratory distress syndrome (ARDS) Arrhythmias considerations in postoperative management of liver transplant patients, 461 462 Artificial extracorporeal liver support (ECLS) systems in ALF and ACLF, 441 442 adverse effects of, 445 447 Ascites cause of, 334 Autoimmune disease cirrhosis due to, 303 B Balloon tamponade in esophageal varices management in liver disease, 375
Index 477 B-ECLS. See Bioartificial extracorporeal liver support (B-ECLS) Biliary complications in liver transplant patients, 465 466 Bioartificial extracorporeal liver support (B-ECLS) in ALF, 446 447 design of, 445 446 Bleeding coagulopathy in liver disease and, 390 in liver disease management of, 391 392 b-blockers in liver disease, 403 C Cardiac cirrhosis, 334 336 Cardiac dysfunction latent in liver disease, 336 in liver disease, 334 clinical implications of, 337 339 Cardiomyopathy cirrhotic pathophysiology of, 337 Cardiovascular medications in liver disease, 402 403 Cardiovascular system considerations in postoperative management of liver transplant patients, 461 462 liver dysfunction in critically ill patients effects on, 430 432 Cerebral edema in ALF and type C HE, 313 Chronic liver disease (CLD) AKI and, 345 Chronic liver failure decompensated, 301 309 vs. acute-on-chronic liver failure, 305 306 Circulatory failure infections in liver disease and, 416 Circulatory system in liver disease, 331 342 Cirrhosis, 301 309 cardiac, 334 336 causes for, 302 303 introduction, 301 309 risk factors for, 302 303 Cirrhosis-associated immunodeficiency pathogenesis of, 414 Cirrhosis-induced systemic inflammation pathogenesis of, 414 415 Cirrhotic cardiomyopathy pathophysiology of, 337
478 Index CLD. See Chronic liver disease (CLD) Coagulation management of in postoperative management of liver transplant patients, 464 Coagulation factors in liver disease, 386 387 liver dysfunction in critically ill patients effects on, 434 Coagulopathy infections in liver disease and, 417 in liver disease clinical implications of, 390 391 Computed tomography (CT) in ALF and overt type C HE, 315 317 Continuous renal replacement therapy (CRRT) in overt type C HE management in ICU, 324 325 Critically ill patients liver dysfunction in, 425 438 coagulation effects of, 434 infectious diseases effects of, 434 435 introduction, 425 nutritional effects of, 433 434 organ systems effects of, 428 434 cardiovascular, 430 432 endocrine, 434 GI, 433 434 hepatic, 433 neurologic, 428 430 renal, 432 433 respiratory, 432 rehabilitation effects of, 435 CT. See Computed tomography (CT) D Detoxification albumin hypothesis and, 441 442 Diastolic dysfunction in liver disease, 337 DIC. See Disseminated intravascular coagulation (DIC) Disseminated intravascular coagulation (DIC) in liver disease, 390 391 Dysmotility in liver disease, 377 380 E ECLS systems. See Extracorporeal liver support (ECLS) systems Edema cerebral in ALF and type C HE, 313
Index 479 Electrophysiologic abnormalities in liver disease, 337 Embolizing large spontaneous portosystemic shunts Encephalopathy hepatic, 311 329 (See also Hepatic encephalopathy (HE)) Endocrine system liver dysfunction in critically ill patients effects on, 434 Esophageal varices in liver disease, 372 375 introduction, 372 management of, 372 375 balloon tamponade in, 375 rescue therapies in, 375 TIPS in, 375 Extracorporeal liver support (ECLS) systems in ALF and ACLF, 439 451 future directions in, 447 448 pooling of data in meta-analysis, 447 rationale for, 440 artificial in ALF and ACLF, 441 442 adverse effects of, 445 447 bioartificial in ALF, 446 447 design of, 445 446 F Fibrinolysis in liver disease, 387 Fluid retention in liver failure, 334 Fractionated plasma separation and adsorption, 444 445 Fungal infections in liver disease, 420 G Gastric varices in liver disease, 375 376 Gastrointestinal (GI) bleeding in liver disease, 372 376 esophageal varices and, 372 375 management of antibiotics in, 419 nonvariceal in liver disease, 376 377 Gastrointestinal (GI) issues in liver disease, 371 384, 403 404 acid suppression, 403 404
480 Index Gastrointestinal (continued) antiemetics, 404 gastric varices, 375 376 GI bleeding, 372 376 nonvariceal, 376 377 introduction, 371 372 MARS, 404 nutritional concerns and dysmotility, 377 380 Gastrointestinal (GI) system liver dysfunction in critically ill patients effects on, 433 434 GI. See Gastrointestinal (GI) H HE. See Hepatic encephalopathy (HE) Hematological issues in liver disease, 385 396, 405 406 coagulation factors, 386 387 coagulopathy in clinical implications of, 390 391 diagnosis of, 388 390 fibrinolysis, 387 introduction, 385 386 management of, 391 393 mechanisms of, 386 387 platelet issues, 387 vwf, 387 Hemodynamic resuscitation in infections in liver disease management, 418 Hemorrhage postoperative in liver transplant patients, 465 Heparin-induced thrombocytopenia in liver disease, 406 Hepatic encephalopathy (HE), 311 329 classification of, 312 clinical features of, 313 evaluation of approach to, 313 neurologic assessment in, 313 314 serial laboratory testing in objectives of, 314 infections in liver disease and, 417 introduction, 311 overt type C cerebral edema in, 313 clinical and laboratory assessment in, 315 318 CT in, 315 317 in ICU management of, 323 326 mortality related to, 313
Index 481 MRI in, 318 neurologic assessment of, 313 314 treatment of pharmacologic, 318, 320 Hepatic hydrothorax (HH), 360 362 clinical manifestations of, 360 defined, 360 diagnosis of, 360 361 pathophysiology of, 360 treatment of, 361 362 Hepatopulmonary syndrome (HPS), 357 360 clinical manifestations of, 358 considerations in postoperative management of liver transplant patients, 460 461 described, 357 diagnosis of, 359 pathophysiology of, 357 358 treatment of, 359 360 Hepatorenal syndrome, 347 349 causes of, 347 348 defined, 348 diagnosis of, 348 349 epidemiology of, 347 348 management of, 349 HH. See Hepatic hydrothorax (HH) High-volume plasmapheresis (HVP), 445 HPS. See Hepatopulmonary syndrome (HPS) HVP. See High-volume plasmapheresis (HVP) Hydrocortisone in infections in liver disease management, 419 Hyperdynamic circulatory syndrome, 332 334 collateral circulation in, 333 described, 332 333 splanchnic vasodilatation in proposed mechanisms of, 333 334 Hypertension considerations in postoperative management of liver transplant patients, 461 462 intracranial (See Intracranial hypertension) portal pathophysiology of, 332 portopulmonary, 362 365 (See also Portopulmonary hypertension (POPH)) Hypothermia therapeutic I ICU. See Intensive care unit (ICU) Immunodeficiency cirrhosis-associated pathogenesis of, 414
482 Index Immunosuppression considerations in postoperative management of liver transplant patients, 464 465 Infection(s) in liver disease, 411 424 consequences of, 416 417 diagnosis of, 415 416 epidemiology of, 411 413 fungal infections, 420 incidence of, 412 introduction, 411 management of, 417 420 antibiotics in, 419 420 general approach to, 417 419 pathogenesis of, 413 415 prevalence of, 412 resistant infections, 413 risk factors for, 412 413 SBP, 420 significance of, 412 special considerations, 420 types of, 413 Infectious disease(s) considerations in postoperative management of liver transplant patients, 465 liver dysfunction in critically ill patients effects on, 434 435 medications for in liver disease, 406 407 Inflammation systemic cirrhosis-induced pathogenesis of, 414 415 Intensive care unit (ICU) liver disease in patients in hemodynamic monitoring of, 339 340 overt type C HE management in, 323 326 readmission to after liver transplantation, 466 Intracranial hypertension in ALF evaluation of serial laboratory testing in, 314 risk factors for, 314 management of, 320 323 prevention of, 320 323 K Ketoacidosis in liver disease, 349 Kidney(s) liver dysfunction in critically ill patients effects on, 432 433
Index 483 Kidney failure infections in liver disease and, 416 417 Kidney injury in liver disease, 343 355 (See also Acute kidney injury (AKI), in liver disease) L Left ventricular hypertrophy in liver disease, 336 337 Liver in critical illness, 425 438 (See also Critically ill patients, liver dysfunction in) Liver disease(s). See also Cirrhosis; specific types, e.g., Acute-on-chronic liver failure advanced clinical implications of, 305 306 discussion, 306 307 epidemiology of, 303 305 AKI in, 344 347 (See also Acute kidney injury (AKI), in liver disease) cardiac cirrhosis, 334 336 cardiac dysfunction in, 334 clinical implications of, 337 339 latent, 336 causes of, 425 427 circulatory system in, 331 342 cirrhotic cardiomyopathy pathophysiology of, 337 diastolic dysfunction in, 337 electrophysiologic abnormalities in, 337 fluid retention in, 334 GI issues in, 371 384 (See also Gastrointestinal (GI) issues, in liver disease) hematological issues in, 385 396 (See also Hematological issues, in liver disease) hyperdynamic circulatory syndrome and, 332 334 in ICU patients hemodynamic monitoring of, 339 340 infections in, 411 424 (See also specific types and Infection(s), in liver disease) kidney function in assessment of, 345 346 kidney injury in, 343 355 (See also Acute kidney injury (AKI), in liver disease) left ventricular hypertrophy in, 336 337 metabolic acidosis in, 349 350 pharmacologic issues in, 397 410 (See also Pharmacologic issues, in liver disease) renal replacement therapy in, 350 351 respiratory complications in, 357 369 (See also Respiratory complications, in liver disease) systolic dysfunction in, 336 Liver dysfunction in critically ill patients, 425 438 (See also Critically ill patients, liver dysfunction in) Liver failure fluid retention in, 334 Liver kidney transplantation, 351 352 Liver transplantation anesthesia technique in, 454 456
484 Index Liver (continued ) phases of procedure, 454 readmission to ICU after, 466 Liver transplant patients intraoperative management of, 454 456 anesthesia technique in, 454 456 personnel in, 454 phases of, 454 vascular access and monitors in, 456 perioperative care of, 453 474 introduction, 453 454 postoperative management of coagulation-related, 464 complications related to, 465 466 readmission to ICU due to, 466 graft function in, 458 450 immediate, 456 459 infectious disease issues in, 465 protocols for, 458 special considerations, 466 system-based considerations in, 459 465 cardiovascular system, 461 462 immunosuppression, 464 465 metabolic system, 463 464 nervous system, 462 463 renal system, 463 respiratory system, 459 461 M Magnetic resonance imaging (MRI) in ALF and overt type C HE, 318 MARS. See Molecular adsorbent recirculating system (MARS) Medications liver disease effects of (See specific types and Pharmacologic issues, in liver disease) Metabolic acidosis in liver disease, 349 350 Metabolic disease cirrhosis due to, 303 Metabolic system considerations in postoperative management of liver transplant patients, 463 464 Metronidazole in overt type C HE management in ICU, 324 Micronutrient supplementation Molecular adsorbent recirculating system (MARS), 441 ACLF clinical studies and, 441 442 ALF and, 442 445 HVP, 445 inflammatory profile, 444 Prometheus, 444 445
Index 485 SPAD, 444 in liver disease, 404 MRI. See Magnetic resonance imaging (MRI) N Neomycin in overt type C HE management in ICU, 324 Nervous system considerations in postoperative management of liver transplant patients, 462 463 Neurologic medications in liver disease, 399 402 AEDs, 399 analgesics, 402 sedatives, 402 Neurologic system liver dysfunction in critically ill patients effects on, 428 430 Neurotransmitter blockade Non anion gap metabolic acidosis in liver disease, 349 350 Nutrition liver dysfunction in critically ill patients effects on, 433 434 Nutritional concerns in liver disease, 377 380 Nutritional support in infections in liver disease management, 419 P Peritonitis spontaneous bacterial in liver disease, 420 Pharmacologic issues in liver disease, 397 410 (See also specific issues, e.g., Neurologic medications) cardiovascular medications, 402 403 GI issues, 403 404 hematologic issues, 405 406 infectious disease related, 406 407 introduction, 397 398 neurologic medications, 399 402 pharmacokinetic and pharmacodynamic alterations, 398 399 absorption, 398 distribution, 398 metabolism/elimination, 399 pulmonary complications, 403 renal medications, 404 405 Plasma ammonia lowering strategies in ALF management, 323
486 Index Plasma (continued) in overt type C HE management in ICU, 323 324 Platelet issues in liver disease, 387 Pneumonia ventilator-associated considerations in postoperative management of liver transplant patients, 461 POPH. See Portopulmonary hypertension (POPH) Portal hypertension pathophysiology of, 332 Portopulmonary hypertension (POPH), 362 365 clinical manifestations of, 363 considerations in postoperative management of liver transplant patients, 462 described, 362 diagnosis of, 363 364 epidemiology of, 363 pathogenesis of, 363 treatment of, 364 365 Portosystemic shunts embolizing large spontaneous Prometheus, 444 445 Pulmonary complications in liver disease, 403 R Rehabilitation liver dysfunction in critically ill patients effects on, 435 Renal failure infections in liver disease and, 416 417 Renal medications in liver disease, 404 405 Renal replacement therapy in liver disease, 350 351 Renal system considerations in postoperative management of liver transplant patients, 463 liver dysfunction in critically ill patients effects on, 432 433 Renal tubular acidosis in liver disease, 349 350 Rescue therapies in esophageal varices management in liver disease, 375 Respiratory complications in liver disease, 357 369 (See also specific types, e.g., Hepatopulmonary syndrome (HPS)) HH, 360 362 HPS, 357 360 POPH, 362 365 SBPL, 362 Respiratory compromise considerations in postoperative management of liver transplant patients, 459 460
Index 487 Respiratory failure infections in liver disease and, 417 Respiratory system considerations in postoperative management of liver transplant patients, 459 461 ARDS, 460 HPS, 460 461 respiratory compromise, 459 460 VAP, 461 weaning from mechanical ventilatory support, 459 liver dysfunction in critically ill patients effects on, 432 Rifaximin in overt type C HE management in ICU, 324 S SBP. See Spontaneous bacterial peritonitis (SBP) SBPL. See Spontaneous bacterial pleuritis (SBPL) Sedatives in liver disease, 402 Shock infections in liver disease and, 416 Single-pass albumin dialysis (SPAD), 444 SPAD. See Single-pass albumin dialysis (SPAD) Splanchnic vasodilatation in hyperdynamic circulatory syndrome proposed mechanisms of, 333 334 Spontaneous bacterial peritonitis (SBP) in liver disease, 420 Spontaneous bacterial pleuritis (SBPL), 362 Systemic inflammation cirrhosis-induced pathogenesis of, 414 415 Systolic dysfunction in liver disease, 336 T Therapeutic hypothermia Thrombocytopenia heparin-induced in liver disease, 406 Thromboembolism venous in liver disease prevention of, 405 Thrombosis in liver disease, 391 management of, 392 393 prevention of, 391 TIPS. See Transjugular intrahepatic protosystemic shunt (YIPS)
488 Index Transjugular intrahepatic protosystemic shunt (YIPS) in esophageal varices management in liver disease, 375 Transplantation liver (See Liver transplantation; Liver transplant patients) liver kidney, 351 352 V VAP. See Ventilator-associated pneumonia (VAP) Varice(s) esophageal (See also Esophageal varices, in liver disease) in liver disease, 472 475 Vascular anastomoses complications related to in liver transplant patients, 465 466 Vasopressors in liver disease, 402 Venous thromboembolism (VTE) in liver disease prevention of, 405 Ventilator-associated pneumonia (VAP) considerations in postoperative management of liver transplant patients, 461 Viral disease cirrhosis due to, 302 303 von Willebrand factor (vwf) in liver disease, 387 VTE. See Venous thromboembolism (VTE) vwf. See von Willebrand factor (vwf) W Wound complications in liver transplant patients, 465 466