✦ LIBER ✦

Blood lactate as a prognostic marker in acetaminophen-induced acute liver failure

✍ Scribed by Lars E. Schmidt; Fin Stolze Larsen

Publisher: John Wiley and Sons
Year: 2003
Tongue: English
Weight: 67 KB
Volume: 37
Category: Article
ISSN: 0270-9139
DOI: 10.1002/hep.510370530

No coin nor oath required. For personal study only.

✦ Synopsis

Background: Although the King's College Hospital (KCH) selection criteria for emergency liver transplantation in paracetamolinduced acute liver failure are widely used, strategies to improve sensitivity and facilitate earlier transplantation are required. We investigated the use of arterial blood lactate measurement for the identification of transplantation candidates. Methods: In a singlecentre study, we measured arterial blood lactate early (median 4 h) and after fluid resuscitation (median 12 h) in patients admitted to a tertiary-referral intensive-care unit. Threshold values that best identified individuals likely to die without liver transplantation were derived in a retrospective initial sample of 103 patients with paracetamol-induced acute liver failure and applied to a prospective validation sample of 107 patients. Predictive value and speed of identification were compared to those of the KCH criteria. Findings: In the initial sample, median lactate was significantly higher in non-surviving patients than in survivors both in the early samples (8.

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