Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Cardiovascular, Endocrine, Hematologic, Pulmonary, and Renal Considerations

作者：Rahul S. Nanchal, Ram Subramanian, Constantine Jason Karvellas, Steven M. Hollenberg, William Peppard, Kai Singbartl, Jonathon Dean Truwit, Ali H. Al-Khafaji, Alley J. Killian, Mustafa Alquraini, Khalil Ibrahim Alshammari, Fayez Ebrahim Alshamsi, Emilie P. Belley‐Côté, Rodrigo Cartin‐Ceba, Joanna Colleen Dionne, Dragos M. Galusca, David T. Huang, Robert C. Hyzy, Mats Junek, Prem Kandiah, Gagan Kumar, Rebecca L. Morgan, Peter E. Morris, Jody C. Olson, Rita Sieracki, Randolph H. Steadman, Beth E. Taylor, Waleed A. Alhazzani · 发表于：Critical Care Medicine · 年份：2020 · DOI：10.1097/ccm.0000000000004192 · 被引用次数：151 · 研究领域：Liver Disease and Transplantation、Sepsis Diagnosis and Treatment、Hemodynamic Monitoring and Therapy

OBJECTIVES: To develop evidence-based recommendations for clinicians caring for adults with acute or acute on chronic liver failure in the ICU. DESIGN: The guideline panel comprised 29 members with expertise in aspects of care of the critically ill patient with liver failure and/or methodology. The Society of Critical Care Medicine standard operating procedures manual and conflict-of-interest policy were followed throughout. Teleconferences and electronic-based discussion among the panel, as well as within subgroups, served as an integral part of the guideline development. SETTING: The panel was divided into nine subgroups: cardiovascular, hematology, pulmonary, renal, endocrine and nutrition, gastrointestinal, infection, perioperative, and neurology. INTERVENTIONS: We developed and selected population, intervention, comparison, and outcomes questions according to importance to patients and practicing clinicians. For each population, intervention, comparison, and outcomes question, we conducted a systematic review aiming to identify the best available evidence, statistically summarized the evidence whenever applicable, and assessed the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. We used the evidence to decision framework to facilitate recommendations formulation as strong or conditional. We followed strict criteria to formulate best practice statements. MEASUREMENTS AND MAIN RESULTS: In this article, we report 29 ...