Infectious Complications in Critically Ill Liver Failure Patients

Amanda Cheung, Sajal D Tanna, Michael G Ison*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Infections remain a leading cause of morbidity and mortality among patients with liver failure. A number of factors, including relative immune dysfunction and systemic inflammation, bacterial translocation, gut dysbiosis, small intestine bacterial overgrowth, altered bile acid pools, and changes in pH due to acid suppression, contribute to the high rates of infection in this population. Though a range of infections can complicate the course of cirrhotic patients, spontaneous bacterial peritonitis (SBP), cholangitis, and cholecystitis in addition to other infections (i.e. pneumonia, urinary tract infection, bacteremia, and Clostridioides difficile colitis) are more common in this population and will be reviewed in this article. Preventative strategies are directed at minimizing the risk of SBP through the use of targeted antimicrobial prophylaxis. Lastly, the critically ill cirrhotic patient may present with an acute need for liver transplantation. Thus, careful assessment for ongoing infection should be performed and treated to optimize outcomes of transplant, if needed.

Original languageEnglish (US)
Pages (from-to)578-587
Number of pages10
JournalSeminars in Respiratory and Critical Care Medicine
Volume39
Issue number5
DOIs
StatePublished - Jan 1 2018

Fingerprint

Liver Failure
Critical Illness
Infection
Peritonitis
Dysbiosis
Bacterial Translocation
Cholecystitis
Cholangitis
Colitis
Bacteremia
Bile Acids and Salts
Urinary Tract Infections
Liver Transplantation
Population
Small Intestine
Pneumonia
Inflammation
Morbidity
Transplants
Acids

Keywords

  • UTI
  • bacteremia and C. difficile colitis
  • cholangitis
  • cholecystitis
  • cirrhosis
  • pneumonia
  • spontaneous bacterial peritonitis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

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title = "Infectious Complications in Critically Ill Liver Failure Patients",
abstract = "Infections remain a leading cause of morbidity and mortality among patients with liver failure. A number of factors, including relative immune dysfunction and systemic inflammation, bacterial translocation, gut dysbiosis, small intestine bacterial overgrowth, altered bile acid pools, and changes in pH due to acid suppression, contribute to the high rates of infection in this population. Though a range of infections can complicate the course of cirrhotic patients, spontaneous bacterial peritonitis (SBP), cholangitis, and cholecystitis in addition to other infections (i.e. pneumonia, urinary tract infection, bacteremia, and Clostridioides difficile colitis) are more common in this population and will be reviewed in this article. Preventative strategies are directed at minimizing the risk of SBP through the use of targeted antimicrobial prophylaxis. Lastly, the critically ill cirrhotic patient may present with an acute need for liver transplantation. Thus, careful assessment for ongoing infection should be performed and treated to optimize outcomes of transplant, if needed.",
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Infectious Complications in Critically Ill Liver Failure Patients. / Cheung, Amanda; Tanna, Sajal D; Ison, Michael G.

In: Seminars in Respiratory and Critical Care Medicine, Vol. 39, No. 5, 01.01.2018, p. 578-587.

Research output: Contribution to journalArticle

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