Proposed algorithm for the management of patients with acute-on-chronic liver failure (ACLF) or decompensated cirrhosis. Proposed algorithm for the management.

Slides:

Advertisements

Similar presentations

Kaplan-Meier survival curves by frequency of exacerbations in patients with COPD: group A, patients with no acute exacerbations of COPD; group B, patients.

Advertisements

Categorisation of direct and indirect admissions to the intensive care unit (ICU) from emergency departments (EDs), using source of admission. Categorisation.

Chart 1: Oxygen prescription for acutely hypoxaemic patients in hospital. Chart 1: Oxygen prescription for acutely hypoxaemic patients in hospital. ABG,

Volume 61, Issue 6, Pages (December 2014)

Figure 7 Management algorithm for patients with ACLF

Volume 144, Issue 7, Pages e9 (June 2013)

Tracings of concurrent oesophageal manometry, pH, and impedance.

Example of algorithm for clinical assessment of patients at risk of non-alcoholic fatty liver disease Example of algorithm for clinical assessment.

Chart 3: Working example of oxygen section for hospital prescription charts (two panels are required on the prescription chart because oxygen may change.

Sedentary time was higher in non-alcoholic fatty liver disease (NAFLD) than healthy controls with fewer sedentary to active transitions (data reported.

Example of algorithm for clinical assessment of patients at risk of non-alcoholic fatty liver disease Example of algorithm for clinical assessment.

A, B, C, D show outcome results for individual symptoms using GSRS-IBS scoring system and mean symptom severity scores before and after IBS dietetic management.

Masashi Maeda et al. Heart Asia 2013;5:7-14

Preprocedure patient ranking of aspects of their care important for obtaining satisfaction with their colonoscopy experience (1=high, 15=low for importance)

Integration of prognostic screening tool and development of supportive care intervention using rapid-cycle ‘Plan-Do-Study-Act’ (PDSA) methodology. Integration.

ROC plots of the association of this score, the Rockall Score and the Blatchford Score with RET (a), death (b), and the combined Blatchford outcome (c)

Young people drink significantly less frequently than older people (A), but drink significantly more on each drinking day (panel B). Young people drink.

Percentage change in mean subscale score for nausea/vomiting (A), postprandial fullness/early satiety (B) and bloating (C) for all patients (n=23) and.

A, B, C, D show outcome results for individual symptoms using GSRS-IBS scoring system and mean symptom severity scores before and after IBS dietetic management.

The number of subjects by year (1) assessed in the iron deficiency anaemia clinic and (2) admitted (overnight or day-case) for blood transfusion to treat.

Algorithm for the investigation of patients with elevated cardiac troponin concentrations in the context of an alternative acute illness. Algorithm for.

Area under the receiver operating curve showing 0

Receiver operating characteristic (ROC) curves for the AIMS65 score and Glasgow–Blatchford score (GBS) as predictors of requirement for blood transfusion.

Predicted mortality for intra-admission change in albumin for four different admission values of albumin, calculated for a 74-year-old man with Charlson.

Receiver operating characteristic (ROC) curves for the AIMS65 score and Glasgow–Blatchford score (GBS) as predictors of requirement for high dependency.

Flow diagram of sample selection and reduction of subject numbers by application of exclusion criteria. ‡Data from Medical Record; ‡‡Records missing gender.

The number of subjects by year (1) assessed in the iron deficiency anaemia clinic and (2) admitted (overnight or day-case) for blood transfusion to treat.

Volume 156, Issue 5, Pages e3 (April 2019)

The first Bedside Assessment, Stabilisation and Initial Cardiorespiratory Support (BASICS) prototype (by PW in April 2011, reprinted with his permission).

Flowchart of patients selected for analysis, illustrating the number of patients at each stage of the study. Flowchart of patients selected for analysis,

Predicted mortality for intra-admission change in alanine aminotransferase (ALT), calculated for a 74-year-old man with Charlson Index of 1, no heart failure,

S chart demonstrating the reduction in average days spent on the waiting list for known patients awaiting admission to the intestinal failure unit. S chart.

Diagram showing the normal progression of severe PPH

Important psychosocial and developmental priorities interact and require assessment and monitoring in adolescents and young people (AYP) in transition.

Percentage of all inpatient episodes for selected cardiovascular conditions, by sex and country of the UK, 2012/2013. Percentage of all inpatient episodes.

Log faecal calprotectin concentration (mg/l) in the different diagnostic groups. Log faecal calprotectin concentration (mg/l) in the different diagnostic.

Annual percent change (APC) in age-specific colorectal cancer (CRC), colon cancer and rectal cancer incidence rates in Europe, 1990–2016. *Indicates that.

Individual data and mean of absolute gall bladder emptying (cm3) induced by modified sham feeding (MSF) in controls and patients with slow transit constipation.

Cox regression analysis of the proportion of patients remaining in remission during azathioprine treatment related to minimum observed white blood cell.

Distribution of NEWS in the community by service

Cox regression analysis of the proportion of patients remaining in remission during azathioprine treatment related to diagnosis of inflammatory bowel disease.

Kaplan-Meier survival curves by frequency of exacerbations in patients with COPD: group A, patients with no acute exacerbations of COPD; group B, patients.

Correlation between age-standardised colorectal cancer incidence (left panel) and mortality rates (right panel) and human development index (HDI) in both.

Time to cessation of rectal bleeding in patients with frank bleeding at baseline. Time to cessation of rectal bleeding in patients with frank bleeding.

Cost-effectiveness acceptability frontier for three risk-assessment strategies related to pressure-injury prevention best practices from a US societal.

The QT interval responses to different pacing rates in a patient in group I. The pacing rate was decreased from 110 to 50 beats/min and the QT interval.

Acute necrotic collection (ANC) in a 47-year-old woman with acute necrotising pancreatitis involving the pancreatic parenchyma alone. Acute necrotic collection.

Alcohol-related liver disease algorithm.

Excess mortality risk associated with weekend admission per diagnosis related group may exhibit different temporal patterns depending on whether the cause.

Relationship between organ failure and mortality in acute-on-chronic liver failure (ACLF). Relationship between organ failure and mortality in acute-on-chronic.

Cumulative incidence of calcification (A) and diabetes (B) since birth in smokers and non-smokers in chronic alcoholic pancreatitis, and cumulative incidence.

Thirty-day crude mortality (%) and adjusted weekend admission ORs (±95% CI): effect of non-availability of NEWS, increasing NEWS band and ICU transfer.

Alcohol-related liver disease algorithm.

Cox regression analysis of the proportion of patients remaining in remission after stopping azathioprine treatment related to diagnosis of inflammatory.

Comparison of the area under the receiver operating curves (AUROCs) to predict 28-day (panel A) and 90-day (panel B) mortality of the chronic liver failure.

A 47-year-old man with acute necrotising pancreatitis complicated by infected pancreatic necrosis. A 47-year-old man with acute necrotising pancreatitis.

(A) Ulceration of colonic mucosa with inflamed granulation tissue corresponding to grade 4 of the Nancy index (HES ×200). (A) Ulceration of colonic mucosa.

Inflammation caused by microbes.

Study protocol. Study protocol. (A) Patients were randomly allocated to placebo or amitriptyline treatment for four weeks. At the end of the month there.

Determinants of moderate Cardiovascular Health Index Score (achieving three or more risk factor targets), stratified by region conventions as in figure.

Predicted mortality for intra-admission change in albumin, calculated for a 74-year-old man with Charlson Index of 1, no heart failure, admission albumin.

Proportions of the social isolation—AMI and stroke excess risk mediated by biological, behavioural, socioeconomic and health-related factors. Proportions.

(A) Trends in colorectal cancer incidence and mortality in males (M) and females (F) by country (group 1: increasing or stable incidence and mortality).

Comparison of heart failure admissions rates per annum (recorded hospital admissions/ population at risk) in western developed countries 1978 to.

Study design. Study design. Patients who completed the 8-week induction study and achieved clinical response-100 (decrease in Crohn's disease activity.

Receiver operating curve for faecal calprotectin in detecting patients with colorectal neoplasia (carcinoma and adenoma). Receiver operating curve for.

Kaplan-Meier survival curves by severity of exacerbations in patients with COPD: (1) no acute exacerbations of COPD; (2) patients with acute exacerbations.

Gall bladder volumes (mean (SEM)) in the fasting state, during, and after modified sham feeding (MSF) and in response to cholecystokinin (CCK) infusion.

(A) Percentage of patients achieving remission or response at week 12 or 24 after initiating ova therapy. (A) Percentage of patients achieving remission.

Change in COPD (chronic obstructive pulmonary disease) assessment test (CAT) score after pulmonary rehabilitation corresponding to different responses.

Presentation transcript:

Proposed algorithm for the management of patients with acute-on-chronic liver failure (ACLF) or decompensated cirrhosis. Proposed algorithm for the management of patients with acute-on-chronic liver failure (ACLF) or decompensated cirrhosis. A proposed management strategy for patients with ACLF based on mortality rate data from the CANONIC study.8 The first step is the assessment of ACLF grade at days 3–7 after initiation of medical management, including organ support. Liver transplantation should be assessed in all patients with ACLF because of high 90-day mortality rates (>20%). Liver transplantation should be performed as early as possible in patients with ACLF grade 2 and grade 3 as they are at considerable risk of short-term (28-day) mortality. In the case of contraindication of liver transplantation, the presence of four or more organ failures (OFs) or a Chronic Liver Failure Consortium (CLIF-C) ACLF score of >64 at days 3–7 after diagnosis could indicate the futility of care. ICU, intensive care unit. Adapted from Gustot et al51 and obtained from Arroyo et al27 with permission. Ruben Hernaez et al. Gut 2017;66:541-553 Copyright © BMJ Publishing Group Ltd & British Society of Gastroenterology. All rights reserved.