ArticleLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society2015
Therapeutic hypothermia in acute liver failure: a multicenter retrospective cohort analysis.
Article in Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00518440 (A Multi-Center Trial to Study Acute Liver Failure in Adults), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Multi-Center Trial to Study Acute Liver Failure in Adults
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 77 citations in OpenAlex.
- Targeted temperature management in acute liver failure: A systematic review.Nursing in critical care · 2022Pooled it
- Diagnosis and management of pediatric acute liver failure: consensus recommendations of the Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ISPGHAN).Hepatology international · 2024Review
- Temperature control after cardiac arrest.Resuscitation · 2023Review
- Targeted temperature management with hypothermia for comatose patients after cardiac arrest.Clinical and experimental emergency medicine · 2023Article
- Clinical and Neurologic Outcomes in Acetaminophen-Induced Acute Liver Failure: A 21-Year Multicenter Cohort Study.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2021Article
- Effect of Therapeutic Hypothermia on Liver Enzymes in Patients With Stroke.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2020Article
- Therapeutic hypothermia after cardiac arrest during living-donor liver transplant surgery: A case report.Medicine · 2020Article
- Acute Liver Failure.Clinical liver disease · 2020Review
- Early General Hypothermia Improves Motor Function after Spinal Cord Injury in Rats; a Systematic Review and Meta-Analysis.Archives of academic emergency medicine · 2020Review
- Induction of selective liver hypothermia prevents significant ischemia/reperfusion injury in Wistar rats after 24 hours.Acta cirurgica brasileira · 2020Article
- Intensive Care Management of Acute Liver Failure: Considerations While Awaiting Liver Transplantation.Journal of clinical and translational hepatology · 2019Review
- Acute mental change as the presenting sign of posthepatectomy hepatic failure: A case report.Medicine · 2019Article
- A case of chronic hepatitis B merged with acute fatty liver of pregnancy with severe coagulopathy.JA clinical reports · 2019Article
- Neurological Monitoring in Acute Liver Failure.Journal of clinical and experimental hepatology · 2018Review
- Outcome of in- and out-of-hospital cardiac arrest survivors with liver cirrhosis.Annals of intensive care · 2017Article
- Managing the patient with acute liver failure.Clinical liver disease · 2017Review
- Reply: To PMID 25308108.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2015Article
- Antibiotics in Acute Liver Failure (ALF).Journal of clinical and experimental hepatology · 2015Article
- Indian National Association for the Study of Liver Consensus Statement on Acute Liver Failure (Part-2): Management of Acute Liver Failure.Journal of clinical and experimental hepatologyReview
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
Abstract
The benefit of therapeutic hypothermia (TH) in acute liver failure (ALF) has not been previously demonstrated in a controlled fashion. This study sought to determine the impact of TH on 21-day survival and complications in ALF patients at high risk for cerebral edema. This was a retrospective cohort study of ALF patients in the US Acute Liver Failure Study Group with grade III or IV hepatic encephalopathy. TH (32°C-35°C) was used in 97 patients (8%); 1135 (92%) who were not cooled were controls. Intracranial pressure was monitored in 38 TH ALF patients (39.2% versus 22% of controls, P < 0.001). Rates of bleeding (12% for both) and bloodstream (17% versus 18%) and tracheal infections (21% versus 23%, P > 0.5 for all) were similar. Unadjusted 21-day overall (62% versus 60%) and transplant-free survival rates (45% versus 39%, P > 0.4 for both) were similar. Multivariate models were created for acetaminophen (APAP) patients (n = 582) and non-APAP patients (n = 613). For APAP patients, the Model for End-Stage Liver Disease [MELD; odds ratio (OR) = 0.91 per increment, 95% confidence interval (CI) = 0.89-0.94, P < 0.001] and vasopressors (OR = 0.16, 95% CI = 0.11-0.24, P < 0.001) were associated with decreased 21-day spontaneous survival. Survival was improved with TH in APAP patients who were <25 years old (age of 25 years: OR = 2.735, 95% CI = 1.001-7.467) but worsened for APAP patients who were 64 years old or older (age of 64 years: OR = 0.167, 95% CI = 0.028-0.999). For non-APAP patients, MELD (OR = 0.93 per increment, 95% CI = 0.91-0.95, P < 0.001) and vasopressors (OR = 0.60, 95% CI = 0.40-0.90, P = 0.01) were associated with worse outcomes, whereas TH had no impact (P = 0.93). In conclusion, TH in ALF was not associated with increased bleeding or infections. Although young APAP ALF patients may benefit, TH did not consistently affect 21-day survival. A prospective trial is required to clarify the utility of TH in ALF patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.