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<p>We investigated the occurrence and outcome of respiratory failure and ARDS in critically ill patients with liver cirrhosis. This is a retrospective analysis of patients with liver cirrhosis at an ICU during an 8-Year period. An assessment of acute on chronic liver failure as well as the presence and grade of ARDS within the first 72&#xa0;h of admission to the ICU was performed. A total of 735 patients during the study period. Median age was 58 (50–69) years and 61% (<i>n</i> = 447) were male. 57% (<i>n</i> = 421) of the patients received mechanical ventilation (MV). Liver specific as well as ICU scores on admission were significantly higher in patients with MV. Necessity of vasopressor support (86%vs.25%, <i>p</i> &lt; 0.001) and RRT (50%vs.11%, <i>p</i> &lt; 0.001) was more frequent in patients with MV. The incidence of ARDS within the first 72&#xa0;h of admission was 8% (<i>n</i> = 61). We observed a 28-day mortality or liver transplantation rate of 54% (<i>n</i> = 196) and 66% (<i>n</i> = 66%) in patients with MV and ARDS, respectively. After 90-days 63% (<i>n</i> = 226) with MV and 70% (<i>n</i> = 43) with ARDS were dead or received liver transplantation. ARDS is a prognostic factor for mortality in patients with liver cirrhosis admitted to the ICU. One out of ten critically ill cirrhotic patients develop ARDS within 72&#xa0;h after admission. Although mortality rates are high initially critical care therapy should not be withheld and must be reevaluated regularly.</p>

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Impact of acute respiratory distress syndrome on outcome in critically ill patients with liver cirrhosis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月4日

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  • Pischtaz Adel Tariparast,
  • Kevin Roedl,
  • Thomas Horvatits,
  • Andreas Drolz,
  • Stefan Kluge,
  • Valentin Fuhrmann

摘要

We investigated the occurrence and outcome of respiratory failure and ARDS in critically ill patients with liver cirrhosis. This is a retrospective analysis of patients with liver cirrhosis at an ICU during an 8-Year period. An assessment of acute on chronic liver failure as well as the presence and grade of ARDS within the first 72 h of admission to the ICU was performed. A total of 735 patients during the study period. Median age was 58 (50–69) years and 61% (n = 447) were male. 57% (n = 421) of the patients received mechanical ventilation (MV). Liver specific as well as ICU scores on admission were significantly higher in patients with MV. Necessity of vasopressor support (86%vs.25%, p < 0.001) and RRT (50%vs.11%, p < 0.001) was more frequent in patients with MV. The incidence of ARDS within the first 72 h of admission was 8% (n = 61). We observed a 28-day mortality or liver transplantation rate of 54% (n = 196) and 66% (n = 66%) in patients with MV and ARDS, respectively. After 90-days 63% (n = 226) with MV and 70% (n = 43) with ARDS were dead or received liver transplantation. ARDS is a prognostic factor for mortality in patients with liver cirrhosis admitted to the ICU. One out of ten critically ill cirrhotic patients develop ARDS within 72 h after admission. Although mortality rates are high initially critical care therapy should not be withheld and must be reevaluated regularly.