ArticleAnnals of intensive care2018
Acid-base status and its clinical implications in critically ill patients with cirrhosis, acute-on-chronic liver failure and without liver disease.
Article in Annals of intensive care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 39 citations in OpenAlex.
- Dynamic Lactate-to-Albumin Ratio Trajectories and Outcomes in Sepsis-Associated Acute Kidney Injury: Evidence From MIMIC-IV and a Multicenter Chinese Cohort.JMIR medical informatics · 2026Observational
- Association of ACAG with short-term mortality in liver failure patients: a retrospective analysis based on the MIMIC-IV database.Scientific reports · 2026Article
- Intraoperative lactate level and lactate clearance is associated with long-term mortality in liver transplant recipients.Anesthesia and pain medicine · 2026Article
- Exploring Cirrhosis: Insights into Advances in Therapeutic Strategies.International journal of molecular sciences · 2025Review
- Sodium bicarbonate in treating lactic and non-lactic metabolic acidosis at different chloride levels: a retrospective study.BMC pediatrics · 2025Article
- Hypochloremia is an underutilised prognostic marker in patients with advanced liver cirrhosis and liver failure.World journal of hepatology · 2025Review
- Lactate-to-albumin ratio as a potential prognostic predictor in patients with cirrhosis and sepsis: a retrospective cohort study.BMC infectious diseases · 2025Article
- TCDCA inhibits pyroptosis to alleviate sepsis-related acute hepatic injury via activating TGR5.Frontiers in immunology · 2025Article
- Increased serum albumin corrected anion gap levels are associated with poor prognosis in septic patients with liver cirrhosis.Scientific reports · 2024Article
- [Ethical aspects regarding the management of patients with liver disease in the intensive care unit].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Review
- Clinical efficacy of sodium bicarbonate in treating pediatric metabolic acidosis with varying level of acid-base balance parameters: a real-world study.BMC medicine · 2023Article
- The association between serum anion gap and all-cause mortality of unselected adult patients: A retrospective cohort study of >20,000 patients.Journal of clinical laboratory analysis · 2023Article
- Characteristics and predictors of short-term mortality in decompensated cirrhotic patients with acute-on-chronic liver failure.Clinical and experimental hepatology · 2022Article
- Intraoperative lactic acid concentration during liver transplantation and cutoff values to predict early mortality: a retrospective analysis of 3,338 cases.Anesthesia and pain medicine · 2022Article
- [Alkalosis, albumin, ammonia and hepatic encephalopathy].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2021Article
- Admission Serum Bicarbonate Predicts Adverse Clinical Outcomes in Hospitalized Cirrhotic Patients.Canadian journal of gastroenterology & hepatology · 2021Article
- Acid-base disorders in sick goats and their association with mortality: A simplified strong ion difference approach.Journal of veterinary internal medicine · 2020Article
- Prognostic Value of Acute-On-Chronic Liver Failure (ACLF) Score in Critically Ill Patients with Cirrhosis and ACLF.Medical science monitor : international medical journal of experimental and clinical research · 2020Article
- Metabolic acidosis in critically ill patients with cirrhosis: Epidemiology and short-term mortality risk factors.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2019Article
- Respiratory and metabolic acidosis correction with the ADVanced Organ Support system.Intensive care medicine experimental · 2019Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcid-base disturbances are frequently observed in critically ill patients at the intensive care unit. To our knowledge, the acid-base profile of patients with acute-on-chronic liver failure (ACLF) has not been evaluated and compared to critically ill patients without acute or chronic liver disease.
resultsOne hundred and seventy-eight critically ill patients with liver cirrhosis were compared to 178 matched controls in this post hoc analysis of prospectively collected data. Patients with and without liver cirrhosis showed hyperchloremic acidosis and coexisting hypoalbuminemic alkalosis. Cirrhotic patients, especially those with ACLF, showed a marked net metabolic acidosis owing to increased lactate and unmeasured anions. This metabolic acidosis was partly antagonized by associated respiratory alkalosis, yet with progression to ACLF resulted in acidemia, which was present in 62% of patients with ACLF grade III compared to 19% in cirrhosis patients without ACLF. Acidemia and metabolic acidosis were associated with 28-day mortality in cirrhosis. Patients with pH values < 7.1 showed a 100% mortality rate. Acidosis attributable to lactate and unmeasured anions was independently associated with mortality in liver cirrhosis.
conclusionsCirrhosis and especially ACLF are associated with metabolic acidosis and acidemia owing to lactate and unmeasured anions. Acidosis and acidemia, respectively, are associated with increased 28-day mortality in liver cirrhosis. Lactate and unmeasured anions are main contributors to metabolic imbalance in cirrhosis and ACLF.
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