Five-day outcome of hepatitis E-induced acute liver failure in the ICU
| Autor: | Simon D. Taylor-Robinson, Cathryn Edwards, Farhana Mahmood, Debashis Chowdhury |
|---|---|
| Přispěvatelé: | Trustees of the London Clinic |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
RD1-811 medicine.medical_treatment RC799-869 Liver transplantation law.invention 03 medical and health sciences 0302 clinical medicine law Internal medicine medicine Intensive care unit Mannitol 030212 general & internal medicine Original Research Article Prospective cohort study Hepatic encephalopathy General Environmental Science business.industry Glasgow Coma Scale Hepatitis A Hepatology Diseases of the digestive system. Gastroenterology medicine.disease Hepatitis E 3. Good health General Earth and Planetary Sciences 030211 gastroenterology & hepatology Surgery business Acute liver failure |
| Zdroj: | Egyptian Liver Journal Egyptian Liver Journal, Vol 11, Iss 1, Pp 1-9 (2021) |
| ISSN: | 2090-6226 |
| Popis: | BackgroundHepatitis E virus (HEV) is an important cause of acute liver failure (ALF) in Bangladesh with pregnant mothers being more vulnerable. As HEV occurs in epidemics, it limits medical capabilities in this resource-poor country. Cerebral oedema, resulting in raised intracranial pressure (ICP), is an important cause of morbidity and mortality. Practical treatments are currently few.To study the baseline characteristics and clinical outcome of HEV-induced ALF in a recent HEV epidemicTo detect raised ICP clinically and observe response to mannitol infusion.This was a prospective cohort study from June until August 2018 of 20 patients admitted to the intensive care unit (ICU) of a major Bangladeshi Referral Hospital with HEV-induced ALF. We diagnosed HEV infection by detecting serum anti-HEV IgM antibody. All were negative for hepatitis B surface antigen and hepatitis A IgM antibody. Data were collected on 5-day outcome after admission to ICU, monitoring all patients for signs of raised ICP. An intravenous bolus of 20% mannitol was administered at a single time point to patients with raised ICP.ResultsTwenty patients were included in the study. Ten (50%) patients, seven (70%) females, received mannitol infusion. HE worsened in eight (40%): seven female and three pregnant. Glasgow Coma scores deteriorated in six (30%): all (100%) females and three pregnant. Consciousness status was not significantly different between pregnant and non-pregnant subjects, nor between those who received mannitol and those who did not. Six patients met King’s College Criteria for liver transplantation.ConclusionsFemale patients had a worse outcome, but pregnancy status was not an additional risk factor in our cohort. Mannitol infusion was also not associated with a significant difference in outcome. |
| Databáze: | OpenAIRE |
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