Abstract | PURPOSE OF REVIEW: RECENT FINDINGS: The predominant mechanism of ACLF is thought to be a systemic inflammatory reaction. Cardiovascular-active factors such as tumor necrosis factor and nitric oxide are increased and cortisol is decreased; the former further dilates the vasculature and the latter decreases the sensitivity to vasoconstrictors. The exaggerated vasodilatation further decreases the cardiac afterload. However, no study has yet demonstrated the benefit of vasodilators/ vasoconstrictors in the management of ACLF. Standard medical treatment in this setting is associated with high mortality. Patients treated with molecular adsorbent recirculating system (MARS) had improved serum levels of inflammatory mediators such as tumor necrosis factor alpha and interleukin-6, but this was not associated with improved survival. Liver transplantation eventually reverses the cardiovascular abnormalities. SUMMARY:
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Authors | Hongqun Liu, Samuel S Lee |
Journal | Current opinion in critical care
(Curr Opin Crit Care)
Vol. 17
Issue 2
Pg. 190-4
(Apr 2011)
ISSN: 1531-7072 [Electronic] United States |
PMID | 21326096
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Biomarkers
(blood)
- Cardiomyopathies
(etiology, physiopathology)
- End Stage Liver Disease
(complications, surgery)
- Hemodynamics
(physiology)
- Humans
- Inflammation
- Liver Failure, Acute
(complications, surgery)
- Liver Transplantation
- Shock
(etiology)
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