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Clinical impact of arterial ammonia levels in ICU patients with different liver diseases

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Clinical impact of arterial ammonia levels in ICU patients with different liver diseases. / Drolz, Andreas; Jäger, Bernhard; Wewalka, Marlene; Saxa, Reinhard; Horvatits, Thomas; Roedl, Kevin; Perkmann, Thomas; Zauner, Christian; Kramer, Ludwig; Ferenci, Peter; Fuhrmann, Valentin.

in: INTENS CARE MED, Jahrgang 39, Nr. 7, 01.07.2013, S. 1227-37.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Drolz, A, Jäger, B, Wewalka, M, Saxa, R, Horvatits, T, Roedl, K, Perkmann, T, Zauner, C, Kramer, L, Ferenci, P & Fuhrmann, V 2013, 'Clinical impact of arterial ammonia levels in ICU patients with different liver diseases', INTENS CARE MED, Jg. 39, Nr. 7, S. 1227-37. https://doi.org/10.1007/s00134-013-2926-8

APA

Drolz, A., Jäger, B., Wewalka, M., Saxa, R., Horvatits, T., Roedl, K., Perkmann, T., Zauner, C., Kramer, L., Ferenci, P., & Fuhrmann, V. (2013). Clinical impact of arterial ammonia levels in ICU patients with different liver diseases. INTENS CARE MED, 39(7), 1227-37. https://doi.org/10.1007/s00134-013-2926-8

Vancouver

Drolz A, Jäger B, Wewalka M, Saxa R, Horvatits T, Roedl K et al. Clinical impact of arterial ammonia levels in ICU patients with different liver diseases. INTENS CARE MED. 2013 Jul 1;39(7):1227-37. https://doi.org/10.1007/s00134-013-2926-8

Bibtex

@article{eabf4c72b4f24fefacb1ed66a4c2e650,
title = "Clinical impact of arterial ammonia levels in ICU patients with different liver diseases",
abstract = "PURPOSE: Increased arterial ammonia levels are associated with high mortality in patients with acute liver failure (ALF). Data on the prognostic impact of arterial ammonia is lacking in hypoxic hepatitis (HH) and scarce in critically ill patients with cirrhosis.METHODS: The patient cohort comprised 72 patients with HH, 43 patients with ALF, 100 patients with liver cirrhosis and 45 patients without evidence for liver disease. Arterial ammonia concentrations were assessed on a daily basis in all patients and the results were compared among these four patient groups and between 28-day survivors and 28-day non-survivors overall and in each group.RESULTS: Overall 28-day mortality rates in patients with HH, ALF and cirrhosis and in the control group were 54, 30, 49 and 27 %, respectively. Peak arterial ammonia levels differed significantly between transplant-free 28-day survivors and non-survivors in the HH and ALF groups (p < 0.01 for both). Multivariate regression identified peak arterial ammonia concentrations as an independent predictor of 28-day mortality or liver transplantation in patients with HH and ALF, respectively (p < 0.01). There was no association between mortality and arterial ammonia in patients with liver cirrhosis and in the control group. Admission arterial ammonia levels were independently linked to hepatic encephalopathy grades 3/4 in patients with HH (p < 0.01), ALF (p < 0.05) and cirrhosis (p < 0.05), respectively.CONCLUSIONS: Elevated arterial ammonia levels indicate a poor prognosis in acute liver injury and are associated with advanced HE in HH, ALF and cirrhosis. Arterial ammonia levels provide additional information in the risk assessment of critically ill patients with liver disease.",
keywords = "Adult, Aged, Ammonia, Austria, Biological Markers, Case-Control Studies, Disease-Free Survival, Female, Hepatitis, Humans, Liver Cirrhosis, Liver Failure, Acute, Logistic Models, Male, Middle Aged, Multivariate Analysis, Prognosis, Prospective Studies",
author = "Andreas Drolz and Bernhard J{\"a}ger and Marlene Wewalka and Reinhard Saxa and Thomas Horvatits and Kevin Roedl and Thomas Perkmann and Christian Zauner and Ludwig Kramer and Peter Ferenci and Valentin Fuhrmann",
year = "2013",
month = jul,
day = "1",
doi = "10.1007/s00134-013-2926-8",
language = "English",
volume = "39",
pages = "1227--37",
journal = "INTENS CARE MED",
issn = "0342-4642",
publisher = "Springer",
number = "7",

}

RIS

TY - JOUR

T1 - Clinical impact of arterial ammonia levels in ICU patients with different liver diseases

AU - Drolz, Andreas

AU - Jäger, Bernhard

AU - Wewalka, Marlene

AU - Saxa, Reinhard

AU - Horvatits, Thomas

AU - Roedl, Kevin

AU - Perkmann, Thomas

AU - Zauner, Christian

AU - Kramer, Ludwig

AU - Ferenci, Peter

AU - Fuhrmann, Valentin

PY - 2013/7/1

Y1 - 2013/7/1

N2 - PURPOSE: Increased arterial ammonia levels are associated with high mortality in patients with acute liver failure (ALF). Data on the prognostic impact of arterial ammonia is lacking in hypoxic hepatitis (HH) and scarce in critically ill patients with cirrhosis.METHODS: The patient cohort comprised 72 patients with HH, 43 patients with ALF, 100 patients with liver cirrhosis and 45 patients without evidence for liver disease. Arterial ammonia concentrations were assessed on a daily basis in all patients and the results were compared among these four patient groups and between 28-day survivors and 28-day non-survivors overall and in each group.RESULTS: Overall 28-day mortality rates in patients with HH, ALF and cirrhosis and in the control group were 54, 30, 49 and 27 %, respectively. Peak arterial ammonia levels differed significantly between transplant-free 28-day survivors and non-survivors in the HH and ALF groups (p < 0.01 for both). Multivariate regression identified peak arterial ammonia concentrations as an independent predictor of 28-day mortality or liver transplantation in patients with HH and ALF, respectively (p < 0.01). There was no association between mortality and arterial ammonia in patients with liver cirrhosis and in the control group. Admission arterial ammonia levels were independently linked to hepatic encephalopathy grades 3/4 in patients with HH (p < 0.01), ALF (p < 0.05) and cirrhosis (p < 0.05), respectively.CONCLUSIONS: Elevated arterial ammonia levels indicate a poor prognosis in acute liver injury and are associated with advanced HE in HH, ALF and cirrhosis. Arterial ammonia levels provide additional information in the risk assessment of critically ill patients with liver disease.

AB - PURPOSE: Increased arterial ammonia levels are associated with high mortality in patients with acute liver failure (ALF). Data on the prognostic impact of arterial ammonia is lacking in hypoxic hepatitis (HH) and scarce in critically ill patients with cirrhosis.METHODS: The patient cohort comprised 72 patients with HH, 43 patients with ALF, 100 patients with liver cirrhosis and 45 patients without evidence for liver disease. Arterial ammonia concentrations were assessed on a daily basis in all patients and the results were compared among these four patient groups and between 28-day survivors and 28-day non-survivors overall and in each group.RESULTS: Overall 28-day mortality rates in patients with HH, ALF and cirrhosis and in the control group were 54, 30, 49 and 27 %, respectively. Peak arterial ammonia levels differed significantly between transplant-free 28-day survivors and non-survivors in the HH and ALF groups (p < 0.01 for both). Multivariate regression identified peak arterial ammonia concentrations as an independent predictor of 28-day mortality or liver transplantation in patients with HH and ALF, respectively (p < 0.01). There was no association between mortality and arterial ammonia in patients with liver cirrhosis and in the control group. Admission arterial ammonia levels were independently linked to hepatic encephalopathy grades 3/4 in patients with HH (p < 0.01), ALF (p < 0.05) and cirrhosis (p < 0.05), respectively.CONCLUSIONS: Elevated arterial ammonia levels indicate a poor prognosis in acute liver injury and are associated with advanced HE in HH, ALF and cirrhosis. Arterial ammonia levels provide additional information in the risk assessment of critically ill patients with liver disease.

KW - Adult

KW - Aged

KW - Ammonia

KW - Austria

KW - Biological Markers

KW - Case-Control Studies

KW - Disease-Free Survival

KW - Female

KW - Hepatitis

KW - Humans

KW - Liver Cirrhosis

KW - Liver Failure, Acute

KW - Logistic Models

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Prognosis

KW - Prospective Studies

U2 - 10.1007/s00134-013-2926-8

DO - 10.1007/s00134-013-2926-8

M3 - SCORING: Journal article

C2 - 23636826

VL - 39

SP - 1227

EP - 1237

JO - INTENS CARE MED

JF - INTENS CARE MED

SN - 0342-4642

IS - 7

ER -