Explanipedia

Intensive care unit and hospital mortality for non-COVID critically ill patients before, and during the COVID-19 pandemic in Alberta hospitals: retrospective, observational cohort study Open

Vincent I. Lau, Fadi Hammal, Wendy Sligl, Constantine Karvellas, Demetrios J. Kutsogiannis , et al. · 2025

Objectives The Coronavirus Disease-2019 (COVID-19) pandemic had indirect impacts on healthcare provided to critically ill intensive care unit (ICU) non-COVID patients and their outcomes. Therefore, we examined the effect of the COVID-19 pa…

Hepatitis B Virus Variants and Cytokine Patterns in Acute Liver Failure and Transplant‐Free Survival Open

Nishi Patel, Annie Y. Chen, Carla Osiowy, Valerie Durkalski Mauldin, William M. Lee , et al. · 2025

Background & Aims Only 25% of hepatitis B‐related acute liver failure (HBV‐ALF) patients survive without liver transplantation (transplant‐free survival, TFS). There is limited study of immunological and virological profiles in these patie…

Stakeholder perspectives on the reduction of opioid exposure in ICU: A modified Delphi survey Open

Lize-Mari Du Toit, Sean M. Bagshaw, John Basmaji, Dipayan Chaudhuri, D’Arcy Duquette , et al. · 2025

This study highlights that both patients and families value reducing opioid exposure and exploring alternatives, aligning with healthcare providers' goals. Improved communication and education about opioid use can enhance patient-centered …

Defining Organ Failures in Patients With Cirrhosis: Consensus Statements Open

Jasmohan S. Bajaj, Debbie L. Shawcross, Ashok Choudhury, Constantine Karvellas, Jacqueline G. O’Leary , et al. · 2025

Therapeutic Plasma Exchange in Patients With Acute‐On‐Chronic Liver Failure Improves Survival—An Updated Meta‐Analysis Open

Santhosh E. Kumar, Kausala Sithamparapillai, Ashok Choudhury, P Krishna Bharadwaj, Jonel Trebicka , et al. · 2025

Background and Aim Acute‐on‐chronic liver failure (ACLF) is a syndrome that develops after an acute insult and is associated with organ failures and high short‐term mortality. Plasma exchange (PLEX) is an emerging modality for treating ACL…

Brain CT Scan Diagnostic and Prognostic Value in Patients With Acute Liver Failure and Cerebral Edema: A Multicenter Cohort Study Open

Filipe S. Cardoso, William M. Lee, Constantine Karvellas · 2025

OBJECTIVE: Patients with acute liver failure (ALF) may develop cerebral edema. We aimed to study the CT scan diagnostic and prognostic value among patients with ALF and cerebral edema. DESIGN: International multicenter retrospective cohort…

Acute-on-chronic liver failure (ACLF): the ‘Kyoto Consensus’—steps from Asia Open

Ashok Choudhury, Anand V. Kulkarni, Vinod Arora, Arvinder Singh Soin, A. Kadir Dökmeci , et al. · 2025

Acute-on-chronic liver failure (ACLF) is a condition associated with high mortality in the absence of liver transplantation. There have been various definitions proposed worldwide. The first consensus report of the working party of the Asi…

Serum proteomics of adults with acute liver failure provides mechanistic insights and attractive prognostic biomarkers Open

Katharina Remih, Franziska-Maria Hufnagel, Anna Sophie Karl, Valerie Durkalski‐Mauldin, William M. Lee , et al. · 2025

Acute liver failure (ALF) is a sudden, and severe condition associated with high fatality. More sensitive and specific prognostic scores are urgently needed to facilitate decision-making regarding liver transplantation in patients with ALF…

Stakeholder Perspectives on the Reduction of Opioid Exposure in Icu: A Modified Delphi Survey Open

Lize-Mari Du Toit, Sean M. Bagshaw, John Basmaji, Dipayan Chaudhuri, D’Arcy Duquette , et al. · 2025

Adjunctive Midodrine Therapy for Vasopressor-Dependent Shock in the ICU: A Systematic Review and Meta-Analysis Open

Sebastian Kilcommons, Fadi Hammal, Mostafa Kamaleldin, Dawn Opgenorth, Kirsten M. Fiest , et al. · 2024

OBJECTIVES: To summarize the efficacy of midodrine as an adjunctive therapy in critically ill patients. Safety of midodrine was assessed as a secondary outcome. DATA SOURCES: We performed a systematic review and meta-analysis using a peer-…

Midodrine for the early liberation from vasopressor support in the ICU (LIBERATE): a feasibility study Open

Sebastian Kilcommons, Fadi Hammal, Dawn Opgenorth, Kirsten M. Fiest, Constantine Karvellas , et al. · 2024

This pilot RCT was registered at clinicaltrials.gov (NCT04489589). Registered July 27, 2020. https://clinicaltrials.gov/study/NCT04489589.

Liver assistive devices in acute liver failure: Current use and future directions Open

Victor Dong, Constantine Karvellas · 2024

Acute liver failure (ALF) is a rare syndrome where rapid deterioration of liver function occurs after an acute insult in a patient without prior chronic liver disease and leads to jaundice, hepatic encephalopathy (HE), and oftentimes multi…

Outcomes of patients with acute liver failure not listed for liver transplantation: A cohort analysis Open

Victor Dong, Valerie Durkalski, William M. Lee, Constantine Karvellas · 2024

Background: Acute liver failure (ALF) is a rare condition leading to morbidity and mortality. Liver transplantation (LT) is often required, but patients are not always listed for LT. There is a lack of data regarding outcomes in these pati…

Association of Hepatorenal Syndrome-Acute Kidney Injury with Mortality in Patients with Cirrhosis Requiring Renal Replacement Therapy Open

Augusto Cama-Olivares, Tianqi Ouyang, Tomonori Takeuchi, Shelsea A. St. Hillien, Jevon E. Robinson , et al. · 2024

Key Points In patients with cirrhosis and AKI requiring renal replacement therapy (RRT), hepatorenal syndrome-AKI was not associated with an increased 90-day mortality when compared with other AKI etiologies. Etiology of AKI may not be a c…

Risk evaluation and recipient selection in adult liver transplantation: A mixed-methods survey Open

Christian Vincelette, Philémon Mulongo, Jeanne‐Marie Giard, Éva Amzallag, Adrienne Carr , et al. · 2024

Background: Liver transplant (LT) is the definitive treatment for end-stage liver disease. Limited resources and important post-operative implications for recipients compel judicious risk stratification and patient selection. However, litt…

Midodrine for the early liberation from vasopressor support in the ICU (LIBERATE): A feasibility study Open

Sebastian Kilcommons, Fadi Hammal, Dawn Opgenorth, Kirsten M. Fiest, Constantine Karvellas , et al. · 2024

Background: Malnutrition is the most common nutritional disorder in developing countries and it remains one of the most common causes of morbidity and mortality among children worldwide. Childhood malnutrition is a multi-dimensional proble…

Macrophage activation markers are associated with infection and mortality in patients with acute liver failure Open

Anna Cavazza, Evangelos Triantafyllou, Roberto Savoldelli, Salma Mujib, Ellen Jerome , et al. · 2024

Background and Aims Acute liver failure is a multisystem disorder with a high mortality and frequent need for emergency liver transplantation. Following massive innate immune system activation, soluble markers of macrophage activation are …

Evidence related to a vegetarian diet and metabolic dysfunction-associated steatotic liver disease: protocol for a scoping review Open

Kasey Moss, Victor Gitman, María Inés Pinto-Sánchez, Simon Oczkowski, David Armstrong , et al. · 2024

Introduction Metabolic dysfunction-associated fatty liver disease (MASLD) is the hepatic manifestation of metabolic syndrome and the leading cause of chronic liver disease worldwide. Given that there is no pharmacological treatment for MAS…

Perturbations in human bile acid profiles following drug‐induced liver injury investigated using semitargeted high‐resolution mass spectrometry Open

Myriam Mireault, Christopher F. Rose, Constantine Karvellas, Lekha Sleno · 2024

Rationale Acetaminophen (APAP) overdose is the leading cause of acute liver failure (ALF) in North America. To investigate the effect of drug‐induced liver injury (DILI) on circulating bile acid (BA) profiles, serum from ALF patients and h…

Protective effects of cyclosporine and its analog NIM-811 in a murine model of hepatic ischemia-reperfusion injury Open

Joshua Hefler, Rena Pawlick, Braulio A. Marfil‐Garza, Aducio Thiesen, Nerea Cuesta‐Gomez , et al. · 2024

Long-Term Follow-Up of Kidney Function after Acute Liver Failure or Acute Liver Injury: A Cohort Study Open

Pedro Fidalgo, Pedro Póvoa, Nuno Germano, Constantine Karvellas, Filipe S. Cardoso · 2024

Introduction: Acute liver failure (ALF) is a rare disease with high mortality. Acute kidney injury (AKI) following ALF is frequent. We assessed AKI impact on long-term kidney function among ALF survivors. Methods: Observational cohort stud…

Stakeholder Perspectives on the Reduction of Opioid Exposure in Icu: A Modified Delphi Survey Open

Lize-Mari Du Toit, Sean M. Bagshaw, John Basmaji, Dipayan Chaudhuri, D’Arcy Duquette , et al. · 2024

Cyclosporine A Does Not Mitigate Liver Ischemia/Reperfusion Injury in an Ex Vivo Porcine Model of Donation After Circulatory Death Open

Joshua Hefler, Sanaz Hatami, Aducio Thiesen, Mitchell J. Wagner, Guilherme Mainardi Aguiar da Silva , et al. · 2023

BACKGROUND Ischemia/reperfusion injury (IRI) is an inherent problem in organ transplantation, owing to the obligate period of ischemia that organs must endure. Cyclosporine A (CsA), though better know as an immunosuppressant, has been show…

What every Intensivist should know about ... Ammonia in liver failure Open

Tiago L. Duarte, Pedro Fidalgo, Constantine Karvellas, Filipe S. Cardoso · 2023

Serum ammonia may have prognostic value in liver failure. Effective ammonia targeted therapeutic strategies are available, such as laxatives, rifaximin, L-ornithine-l-aspartate, and continuous renal replacement therapy.

Letter: Exploring the clinical utility of ammonia in critically ill patients with cirrhosis: More to do? Authors' reply Open

Filipe S. Cardoso, Minjee Kim, Rui Pereira, Luís Bagulho, Pedro Fidalgo , et al. · 2023

LINKED CONTENT This article is linked to Cardoso et al papers. To view these articles, visit https://doi.org/10.1111/apt.17650 and https://doi.org/10.1111/apt.17698

Systemic Nonsteroidal Anti-Inflammatories for Analgesia in Postoperative Critical Care Patients: A Systematic Review and Meta-Analysis of Randomized Control Trials Open

Chen-Hsiang Ma, Kimberly B. Tworek, Janice Y. Kung, Sebastian Kilcommons, Kathleen E. Wheeler , et al. · 2023

OBJECTIVES: While opioids are part of usual care for analgesia in the ICU, there are concerns regarding excess use. This is a systematic review of nonsteroidal anti-inflammatory drugs (NSAIDs) use in postoperative critical care adult patie…

Management of the acute on chronic liver failure in the intensive care unit Open

Constantine Karvellas, Thierry Gustot, Javier Fernández · 2023

Acute on chronic liver failure (ACLF) reflects the development of organ failure(s) in a patient with cirrhosis and is associated with high short‐term mortality. Given that ACLF has many different ‘phenotypes’, medical management needs to t…

The novel SALT-M score predicts 1-year post-transplant mortality in patients with severe acute-on-chronic liver failure Open

Rubén Hernáez, Constantine Karvellas, Yan Liu, Sophie‐Caroline Sacleux, Saro Khemichian , et al. · 2023

Future directions in acute liver failure Open

R. Todd Stravitz, Robert J. Fontana, Constantine Karvellas, Valerie Durkalski, Brendan M. McGuire , et al. · 2023

Acute liver failure (ALF) describes a clinical syndrome of rapid hepatocyte injury leading to liver failure manifested by coagulopathy and encephalopathy in the absence of pre-existing cirrhosis. The hallmark diagnostic features are a prol…

Role of Terlipressin in Patients With Hepatorenal Syndrome-Acute Kidney Injury Admitted to the ICU: A Substudy of the CONFIRM Trial Open

Constantine Karvellas, Ram Subramanian, Jody C. Olson, Khurram Jamil · 2023

IMPORTANCE AND OBJECTIVES: This study assessed the potential advantages of treating hepatorenal syndrome-acute kidney injury (HRS-AKI) with terlipressin versus placebo in the ICU setting. DESIGN: Patients were randomly assigned in a 2:1 ra…

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