ArticleBMC anesthesiology2018
Liver maximum capacity (LiMAx) test as a helpful prognostic tool in acute liver failure with sepsis: a case report.
Article in BMC anesthesiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 20 citations in OpenAlex.
- Obeticholic Acid Improves Cholestasis, Liver Fibrosis, and Liver Function in Patients with Primary Biliary Cholangitis with Inadequate Response to Ursodeoxycholic Acid.Journal of personalized medicine · 2025Article
- Isoflurane, like sepsis, decreases CYP1A2 liver enzyme activity in intensive care patients: a clinical study and network model.Intensive care medicine experimental · 2024Article
- Liver Function-How to Screen and to Diagnose: Insights from Personal Experiences, Controlled Clinical Studies and Future Perspectives.Journal of personalized medicine · 2022Review
- Immunomodulation by Hemoadsorption-Changes in Hepatic Biotransformation Capacity in Sepsis and Septic Shock: A Prospective Study.Biomedicines · 2022Article
- The LiMAx Test as Selection Criteria in Minimally Invasive Liver Surgery.Journal of clinical medicine · 2022Article
- Profound decrease of liver maximum function capacity test of isoflurane sedated patients: A report of three cases.Clinical case reports · 2021Article
- Liver failure-future challenges and remaining questions.Annals of translational medicine · 2021Review
- Pericarditis Caused byCase reports in critical care · 2021Article
- Pharmacokinetics of tigecycline in critically ill patients with liver failure defined by maximal liver function capacity test (LiMAx).Annals of intensive care · 2020Article
- A novel variant of theArchives of toxicology · 2020Article
- [Hepatic dysfunction in patients with cardiogenic shock].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2019Review
- Enzymatic liver function measured by LiMAx - a reliable diagnostic and prognostic tool in chronic liver disease.Scientific reports · 2019Article
- Dosing of Antimycotic Treatment in Sepsis-Induced Liver Dysfunction by Functional Liver Testing with LiMAx®.Case reports in critical care · 2019Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute liver failure (ALF) is a life-threatening entity particularly when infectious complications worsen the clinical course. Urgent liver transplantation (LT) is frequently the only curative treatment. However, in some cases, recovery is observed under conservative treatment. Therefore, prognostic tools for estimating course of the disease are of great clinical interest. Since laboratory parameters sometimes lack sensitivity and specificity, enzymatic liver function measured by liver maximum capacity (LiMAx) test may offer novel and valuable additional information in this setting. CASE PRESENTATION: We here report the case of a formerly healthy 20-year old male caucasian patient who was admitted to our clinic for ALF of unknown origin in December 2017. Laboratory parameters confirmed the diagnosis with an initial MELD score of 28 points. Likewise, enzymatic liver function was significantly impaired with a value of 147 [> 315] μg/h/kg. Clinical and biochemical analyses for viral-, autoimmune-, or drug-induced hepatitis were negative. Liver synthesis parameters further deteriorated reaching a MELD score of 40 points whilst clinical course was complicated by septic pneumonia leading to severe hepatic encephalopathy grade III-IV, finally resulting in mechanical ventilation of the patient. Interestingly, although clinical course and laboratory data suggested poor outcome, serial LiMAx test revealed improvement of the enzymatic liver function at this time point increasing to 169 μg/h/kg. Clinical condition and laboratory data slowly improved likewise, however with significant time delay of 11 days. Finally, the patient could be dismissed from our clinic after 37 days.
conclusionEstimating prognosis in patients with ALF is challenging by use of the established scores. In our case, improvement of enzymatic liver function measured by the LiMAx test was the first parameter predicting beneficial outcome in a patient with ALF complicated by sepsis.
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