Showing papers by "Constantine J. Karvellas published in 2014"
TL;DR: In this article, the intra-and inter-reliability of measuring muscle quadriceps muscle layer thickness (QMLT) using bedside ultrasound was evaluated, and the results showed that the same person measured the subject according to intraclass correlation (ICC).
Abstract: Background: Critically ill patients commonly experience skeletal muscle wasting that may predict clinical outcome. Ultrasound is a noninvasive method that can measure muscle quadriceps muscle layer thickness (QMLT) and subsequently lean body mass (LBM) at the bedside. However, currently the reliability of these measurements are unknown. The objectives of this study were to evaluate the intra- and interreliability of measuring QMLT using bedside ultrasound. Methods: Ultrasound measurements of QMLT were conducted at 7 centers on healthy volunteers. Trainers were instructed to perform measurements twice on each patient, and then a second trainee repeated the measurement. Intrarater reliability measured how consistently the same person measured the subject according to intraclass correlation (ICC). Interrater reliability measured how consistently trainer and trainee agreed when measuring the same subject according to the ICC. Results: We collected 42 pairs of within operator measurements with an ICC of .98 an...
206 citations
TL;DR: Patients with cirrhosis who have been removed from the wait list for LT are infrequently referred for palliative care, although a high percentage have pain or nausea, according to the Edmonton Symptom Assessment System.
167 citations
TL;DR: Sarcopenia was independently predictive of greater complication rates, discharge disposition, and in-hospital mortality in the very elderly emergency surgery population and using sarcopenia as an objective tool to identify high-risk patients would be beneficial in developing tailored preventative strategies and potentially resource allocation in the future.
126 citations
TL;DR: The use of intracranial pressure monitor in acetaminophen acute liver failure did not confer a significant 21-day mortality benefit, whereas in nonacetaminophen Acute Liver Failure, it may be associated with worse outcomes.
Abstract: Objective:To determine if intracranial pressure monitor placement in patients with acute liver failure is associated with significant clinical outcomes.Design:Retrospective multicenter cohort study.Setting:Academic liver transplant centers comprising the U.S. Acute Liver Failure Study Group.Patients
100 citations
TL;DR: Based on a large, observational study, antimicrobial prophylaxis does not reduce the incidence of bloodstream infection or mortality within 21 days of ALF, but bloodstream infections were associated with increased 21-day mortality in patients with ALF-to a greater extent in patients without than with acetaminophen-associated ALF.
49 citations
TL;DR: New definitions for ACLF, cirrhosis-associated AKI and the CLIF-SOFA may improve the discrimination between survivors and nonsurvivors with ACLF.
Abstract: Purpose of reviewTo provide an update on the recent publications for the management and prognostication of critically ill cirrhotic patients before and after liver transplant.Recent findingsThe CLIF Acute-oN-ChrONicLIver Failure in Cirrhosis (CANONIC) study recently derived an evidence-based definit
46 citations
46 citations
TL;DR: Intensive care unit readmission within the initial hospital stay afterLT negatively impacts LT recipients' outcomes and monitoring respiratory rate at discharge from the first ICU stay after LT is important to prevent readmission.
17 citations
TL;DR: Concerns exist that therapeutic hypothermia (TH) may increase the risk of infection, worsen coagulopathy and inhibit hepatic regeneration, and utilization of TH in ALF patients at high risk for cerebral edema is reviewed.
Abstract: Cerebral edema is a severe and life-threatening complication in acute liver failure (ALF). Concerns exist that therapeutic hypothermia (TH) may increase the risk of infection, worsen coagulopathy and inhibit hepatic regeneration. We therefore reviewed the experience in use of TH in participating US Acute Liver Failure Study Group (ALFSG) centers. The aims were to determine utilization of TH in ALF patients at high risk for cerebral edema (grade III or IV hepatic encephalopathy (HE)) and to determine its effect on survival and complication rates.
1 citations
TL;DR: This study evaluated the outcomes of Cirrhotic patients with Model for End-stage Liver Disease (MELD) score ≥40 after liver transplant for high risk of death without liver transplant (LT) after transplant.
Abstract: Cirrhotic patients with Model for End-stage Liver Disease (MELD) score ≥40 have high risk of death without liver transplant (LT) [1] This study aimed to evaluate these patients' outcomes after transplant
1 citations