<< Hepatic Failure: An Evidence- Based Approach In The Emergency Department


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Evidence-based medicine requires a critical appraisal of the literature based upon study methodology and number of subjects. Not all references are equally robust. The findings of a large, prospective, randomized, and blinded trial should carry more weight than a case report.

To help the reader judge the strength of each reference, pertinent information about the study, such as the type of study and the number of patients in the study, will be included in bold type following the reference, where available. In addition, the most informative references cited in this paper, as determined by the authors, will be noted by an asterisk (*) next to the number of the reference.
  1. O'Grady JG, Schalm SW, Williams R. Acute liver failure: redefining the syndromes. Lancet. 1993;342:273-275. (Review article) 
  2. Trey C, Davidson CS. The management of fulminant hepatic failure. In: Popper H, Schaffer F, eds. Progress in Liver Diseases. New York: Grune & Stratton; 1970;282-298. (Textbook chapter) 
  3. Hoofnagle JH, Carithers RL Jr, Shapiro C, et al. Fulminant hepatic failure: summary of a workshop. Hepatology. 1995;21:240-252. (Review article) 
  4. Khashab M, Tector AJ, Kwo PY. Epidemiology of acute liver failure. Curr Gastroenterol Rep. 2007;9:66-73. (Review article) 
  5. Heron M, Hoyert D, Xu J, et al. Deaths: preliminary data for 2006. National Vital Statistics Reports. 2008;56:1-52. (National census summary) 
  6. Polson J, Lee WM. AASLD position paper: the management of acute liver failure. Hepatology. 2005;41:1179-1197.(Evidence-based position statement) 
  7. * Runyon BA. Management of adult patients with ascites due to cirrhosis. Hepatology. 2004;39:841-856. (Evidence-based practice guideline) 
  8. * Garcia-Tsao G, Sanyal AJ, Grace ND, et al. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Am J Gastroenterol. 2007;102:2086-2102.(Evidence-based practice guideline) 
  9. * Ostapowicz G, Fontana RJ, Schiodt FV, et al. Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States. Ann Intern Med. 2002;137:947-954.(Prospective cohort study; 308 acute liver failure patients) 
  10. Schiodt FV, Davern TJ, Shakil AO, et al. Viral hepatitisrelated acute liver failure. Am J Gastroenterol. 2003;98:448-453.(Prospective cohort study; 354 acute liver failure patients) 
  11. Yoshiba M, Dehara K, Inoue K, et al. Contribution of hepatitis C virus to non-A, non-B fulminant hepatitis in Japan.Hepatology.1994;19:829-835. (Nonrandomized comparative study; 30 hepatitis patients) 
  12. Chu CM, Sheen IS, Liaw YF. The role of hepatitis C virus in fulminant viral hepatitis in an area with endemic hepatitis A and B. Gastroenterology. 1994;107:189-195. (Nonrandomized cohort study; 62 patients) 
  13. Lee WM, Squires RH Jr, Nyberg SL, et al. Acute liver failure: summary of a workshop. Hepatology. 2008;47:1401-1415.(Evidence-based meeting report) 
  14. Tanaka M, Watanabe S, Masaki T, et al. Fulminant hepatic failure caused by malignant melanoma of unknown primary origin. J Gastroenterol. 2004;39:804-806. (Case report) 
  15. Schiodt FV, Atillasoy E, Shakil AO, et al. Etiology and outcome for 295 patients with acute liver failure in the United States. Liver Transpl Surg. 1999;5:29-34. (Retrospective cohort study; 295 acute liver failure patients) 
  16. Rolfes DB, Ishak KG. Acute fatty liver of pregnancy: a clinicopathologic study of 35 cases. Hepatology. 1985;5:1149-1158.(Retrospective cohort study; 35 patients) 
  17. Sandle GI, Layton M, Record CO, et al. Fulminant hepatic failure due to Budd-Chiari syndrome. Lancet. 1980;1:1199.(Case report) 
  18. Empen K, Jung MC, Engelhardt D, et al. Successful treatment of acute liver failure due to polyarteritis nodosa. Am J Med. 2002;113:349-351. (Case report) 
  19. Kessler WR, Cummings OW, Eckert G, et al. Fulminant hepatic failure as the initial presentation of acute autoimmune hepatitis. Clin Gastroenterol Hepatol. 2004;2:625-631. (Retrospective study; 115 autoimmune hepatitis patients) 
  20. Koroneos A, Vlachogiannakos J, Stamoulis K, et al. Acute liver failure as the first manifestation of severe traumatic tricuspid valve insufficiency. Intensive Care Med. 2006;32:336- 337. (Case report) 
  21. Brown SW, Clarke MA, Tomlin PI. Fatal liver failure following generalized tonic-clonic seizures. Seizure. 1992;1:75-77.(Case reports) 
  22. * Zimmerman HJ, Maddrey WC. Acetaminophen (paracetamol) hepatotoxicity with regular intake of alcohol: analysis of instances of therapeutic misadventure. Hepatology. 1995;22:767-773. (Retrospective cohort study; 67 patients) 
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  26. * Salerno F, Gerbes A, Gines P, et al. Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis. Gut. 2007;56:1310-1318. (Evidence-based review and consensus recommendations of the International Ascites Club, 2005) 
  27. Arroyo V, Gines P, Gerbes AL, et al. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. International Ascites Club. Hepatology. 1996;23:164- 176. (Evidence based review and consensus recommendations of the International Ascites Club, 1994) 
  28. Alessandria C, Ozdogan O, Guevara M, et al. MELD score and clinical type predict prognosis in hepatorenal syndrome: relevance to liver transplantation. Hepatology. 2005;41:1282- 1289. (Prospective cohort study; 105 HRS patients) 
  29. Rodriguez-Roisin R, Krowka MJ. Hepatopulmonary syndrome -- a liver-induced lung vascular disorder. N Engl J Med. 2008;358:2378-2387. (Review article) 
  30. Schenk P, Schoniger-Hekele M, Fuhrmann V, et al. Prognostic significance of the hepatopulmonary syndrome in patients with cirrhosis. Gastroenterology. 2003;125:1042-1052. (Prospective nonrandomized observational study) 
  31. Swanson KL, Wiesner RH, Krowka MJ. Natural history of hepatopulmonary syndrome: Impact of liver transplantation.Hepatology. 2005;41:1122-1129. (Case-control study; 61 patients with HPS, 77 controls) 
  32. Murray KF, Carithers RL, Jr. AASLD practice guidelines: evaluation of the patient for liver transplantation. Hepatology. 2005;41:1407-1432. (Evidence-based practice guideline) 
  33. Conn HO, Leevy CM, Vlahcevic ZR, et al. Comparison of lactulose and neomycin in the treatment of chronic portalsystemic encephalopathy. A double-blind controlled trial.Gastroenterology. 1977;72:573-583. (Randomized, doubleblind, controlled trial; 33 patients with cirrhosis) 
  34. Munoz SJ. Difficult management problems in fulminant hepatic failure. Semin Liver Dis. 1993;13:395-413. (Review article) 
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  36. Blei AT, Olafsson S, Therrien G, et al. Ammonia-induced brain edema and intracranial hypertension in rats after portacaval anastomosis. Hepatology. 1994;19:1437-1444. (Randomized, controlled trial in rats) 
  37. Clemmesen JO, Larsen FS, Kondrup J, et al. Cerebral herniation in patients with acute liver failure is correlated with arterial ammonia concentration. Hepatology. 1999;29:648-653.(Combined retrospective and prospective observational study; 53 patients total) 
  38. Stair TO, Morrissey J, Jaradeh I, et al. Validation of the Quick Confusion Scale for mental status screening in the emergency department. Intern Emerg Med. 2007;2:130-132. (Nonrandomized prospective comparative study; 666 patients) 
  39. Cattau EL Jr, Benjamin SB, Knuff TE, et al. The accuracy of the physical examination in the diagnosis of suspected ascites. JAMA. 1982;247:1164-1166. (Interrater comparative study; 21 patients) 
  40. Dufour DR, Lott JA, Nolte FS, et al. Diagnosis and monitoring of hepatic injury. II. Recommendations for use of laboratory tests in screening, diagnosis, and monitoring. Clin Chem. 2000;46:2050-2068. (Evidence-based guideline) 
  41. Dufour DR, Lott JA, Nolte FS, et al. Diagnosis and monitoring of hepatic injury. I. Performance characteristics of laboratory tests. Clin Chem. 2000;46:2027-2049. (Evidence-based guideline) 
  42. Tygstrup N, Ranek L. Assessment of prognosis in fulminant hepatic failure. Semin Liver Dis. 1986;6:129-137. (Review article) 
  43. Green RM, Flamm S. AGA technical review on the evaluation of liver chemistry tests. Gastroenterology. 2002;123:1367- 1384. (National guideline) 
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  45. O'Grady JG, Alexander GJ, Hayllar KM, et al. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology. 1989;97:439-445. (Retrospective study; 588 patients with acute liver failure) 
  46. Harrison PM, O'Grady JG, Keays RT, et al. Serial prothrombin time as prognostic indicator in paracetamol induced fulminant hepatic failure. BMJ. 1990;301:964-966. (Retrospective study; 150 patients) 
  47. Dufour DR, et al. Laboratory identification of ischemic hepatitis (shock liver). Clin Chem. 1988;34:1287. (Abstract) 
  48. Fuchs S, Bogomolski-Yahalom V, Paltiel O, et al. Ischemic hepatitis: clinical and laboratory observations of 34 patients.J Clin Gastroenterol. 1998;26:183-186. (Retrospective study; 34 patients) 
  49. Schmidt LE, Larsen FS. Prognostic implications of hyperlactatemia, multiple organ failure, and systemic inflammatory response syndrome in patients with acetaminophen-induced acute liver failure. Crit Care Med. 2006;34(2):337-43. (Prospective observational cohort, 101 patients) 
  50. Rumack et al. Acetaminophen overdose: 662 cases with evaluation of oral acetylcysteine treatment. Arch Intern Med. 1981;141:380-385. 
  51. Bernal W, Donaldson N, Wyncoll D, et al. Blood lactate as an early predictor of outcome in paracetamol-induced acute liver failure: a cohort study. Lancet. 2002;359:558-563. (Retrospective study, 103 patients; prospective validation, 107 patients) 
  52. Macquillan GC, Seyam MS, Nightingale P, et al. Blood lactate but not serum phosphate levels can predict patient outcome in fulminant hepatic failure. Liver Transpl. 2005;11:1073-1079.(Retrospective study; 48 patients) 
  53. Roberts EA, Schilsky ML. Diagnosis and treatment of Wilson disease: an update. Hepatology. 2008;47:2089-2111. (Evidencebased practice guideline) 
  54. Czaja AJ, Freese DK. Diagnosis and treatment of autoimmune hepatitis. Hepatology. 2002;36:479-497. (Evidence-based practice guideline) 
  55. Peters DJ, Greene WH, Ruggiero F, et al. Herpes simplexinduced fulminant hepatitis in adults: a call for empiric therapy. Dig Dis Sci. 2000;45:2399-2404. (Case series [3 cases] and case report review [13 cases]) 
  56. Child CG, Turcotte JG. Surgery and portal hypertension. In: The liver and portal hypertension. Edited by CG Child. Philadelphia: Saunders 1964:50-72. 
  57. Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R (1973). Transection of the oesophagus for bleeding oesophageal varices. The British Journal of Surgery 60 (8): 646649. 
  58. Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33:464-470. (Retrospective derivation) 
  59. UNOS MELD/PELD Calculator. Available at: http://www.http://www.unos.org/resources/MeldPeldCalculator.asp?index=98unos.org/resources/MeldPeldCalculator.asp?index=98. Accessed 3/12/2009, 2009. (Website) 
  60. MELD Score and 90-Day Mortality Rate for Alcoholic Hepatitis online calculator. Available at http://www.mayoclinic. org/meld/mayomodel7.html. Accessed 3/7/2010. (Website) 
  61. Bailey B, Amre DK, Gaudreault P. Fulminant hepatic failure secondary to acetaminophen poisoning: a systematic review and meta-analysis of prognostic criteria determining the need for liver transplantation. Crit Care Med. 2003;31:299-305.(Meta-analysis of 9 studies) 
  62. Alba L, Hay JE, Angulo P, et al. Lactulose therapy in acute liver failure. J Hepatol. 2002;36:33 [abstract]. (Retrospective, case-control study; 117 ALF patients) 
  63. * Als-Nielsen B, Gluud LL, Gluud C. Nonabsorbable disaccharides for hepatic encephalopathy. Cochrane Database Syst Rev. 2004:CD003044. (Meta-analysis of 30 randomized, controlled trials) 
  64. Als-Nielsen B, Koretz RL, Kjaergard LL, et al.Branched-chain amino acids for hepatic encephalopathy. Cochrane Database Syst Rev. 2003:CD001939. (Meta-analysis of 11 randomized, controlled trials; 556 patients) 
  65. Als-Nielsen B, Gluud LL, Gluud C. Dopaminergic agonists for hepatic encephalopathy. Cochrane Database Syst Rev. 2004:CD003047. (Meta-analysis of 5 randomized controlled trials) 
  66. Als-Nielsen B, Gluud LL, Gluud C. Benzodiazepine receptor antagonists for hepatic encephalopathy. Cochrane Database Syst Rev. 2004:CD002798. (Meta-analysis of 13 randomized, controlled trials; 805 patients) 
  67. Bhatia V, Batra Y, Acharya SK. Prophylactic phenytoin does not improve cerebral edema or survival in acute liver failure -- a controlled clinical trial. J Hepatol. 2004;41:89-96. (Randomized, controlled trial; 42 ALF patients) 
  68. Canalese J, Gimson AE, Davis C, Mellon PJ, Davis M, Williams R. Controlled trial of dexamethasone and mannitol for the cerebral oedema of fulminant hepatic failure. Gut. 1982;23:625-629. (Randomized, controlled trial; 44 ALF patients) 
  69. Strauss G, Hansen BA, Knudsen GM, et al. Hyperventilation restores cerebral blood flow autoregulation in patients with acute liver failure. J Hepatol. 1998;28:199-203. (Uncontrolled trial; 7 patients) 
  70. Ede RJ, Gimson AE, Bihari D, et al. Controlled hyperventilation in the prevention of cerebral oedema in fulminant hepatic failure. J Hepatol. 1986;2:43-51. (Randomized, controlled trial; 55 ALF patients) 
  71. Murphy N, Auzinger G, Bernel W, et al. The effect of hypertonic sodium chloride on intracranial pressure in patients with acute liver failure. Hepatology. 2004;39:464-470. (Randomized, controlled trial; 30 ALF patients) 
  72. Jalan R, Olde Damink SW, Deutz NE, et al. Moderate hypothermia in patients with acute liver failure and uncontrolled intracranial hypertension. Gastroenterology. 2004;127:1338- 1346. (Cohort study; 14 patients) 
  73. Jalan R, Olde Damink SW, Deutz NE, et al. Moderate hypothermia for uncontrolled intracranial hypertension in acute liver failure. Lancet. 1999;354:1164-1168. (Cohort study; 7 patients with refractory intracranial hypertension) 
  74. Gazzard BG, Henderson JM, Williams R. Early changes in coagulation following a paracetamol overdose and a controlled trial of fresh frozen plasma therapy. Gut. 1975;16:617- 620. (Randomized, controlled trial) 
  75. Heckman KD, Weiner GJ, Davis CS, et al. Randomized study of prophylactic platelet transfusion threshold during induction therapy for adult acute leukemia: 10,000/microL versus 20,000/microL. J Clin Oncol. 1997;15:1143-1149. (Randomized, controlled trial; 78 patients) 
  76. Rebulla P, Finazzi G, Marangoni F, et al. The threshold differenfor prophylactic platelet transfusions in adults with acute myeloid leukemia. Gruppo Italiano Malattie Ematologiche Maligne dell'Adulto. N Engl J Med. 1997;337:1870-1875. (Randomized, controlled trial; 255 patients) 
  77. Shami VM, Caldwell SH, Hespenheide EE, et al. Recombinant activated factor VII for coagulopathy in fulminant hepatic failure compared with conventional therapy. Liver Transpl. 2003;9:138-143. (Cohort study; 15 ALF patients) 
  78. Wolf SJ, Heard K, Sloan EP, et al. Clinical policy: critical issues in the management of patients presenting to the emergency department with acetaminophen overdose. Ann Emerg Med. 2007;50:292-313. (Evidence-based policy statement) 
  79. Sato RL, Wong JJ, Sumida SM, et al. Efficacy of superactivated charcoal administered late (3 hours) after acetaminophen overdose. Am J Emerg Med. 2003;21:189-191. (Randomized, controlled trial; 46 volunteers) 
  80. Smilkstein MJ, Knapp GL, Kulig KW, et al. Efficacy of oral Nacetylcysteine in the treatment of acetaminophen overdose. Analysis of the National Multicenter Study (1976 to 1985). N Engl J Med. 1988;319:1557-1562. (Multi-center retrospective study; 2540 patients) 
  81. Harrison PM, Keays R, Bray GP, et al. Improved outcome of paracetamol-induced fulminant hepatic failure by late administration of acetylcysteine. Lancet. 1990;335:1572-1573.(Retrospective study; 100 patients with acetaminopheninduced acute hepatic failure) 
  82. Buckley NA, Whyte IM, O'Connell DL, et al. Oral or intravenous N-acetylcysteine: which is the treatment of choice for acetaminophen (paracetamol) poisoning? J Toxicol Clin Toxicol. 1999;37:759-767. (Meta-analysis; 981 patients) 
  83. Dart RC, Erdman AR, Olson KR, et al. Acetaminophen poisoning: an evidence-based consensus guideline for outof- hospital management. Clin Toxicol (Phila). 2006;44:1-18.(Evidence-based guideline) 
  84. Enjalbert F, Rapior S, Nouguier-Soule J, et al. Treatment of amatoxin poisoning: 20-year retrospective analysis. J Toxicol Clin Toxicol. 2002;40:715-757. (Retrospective study; 2108 amatoxin cases) 
  85. Sorrell MF, Belongia EA, Costa J, et al. National Institutes of Health Consensus Development Conference Statement: management of hepatitis B. Ann Intern Med. 2009;150:104- 110. (Evidence-based consensus statement) 
  86. Gines P, Quintero E, Arroyo V, et al. Compensated cirrhosis: natural history and prognostic factors. Hepatology. 1987;7:122-128. (Cohort study; 293 cirrhotic patients) 
  87. Webster ST, Brown KL, Lucey MR, et al. Hemorrhagic complications of large volume abdominal paracentesis. Am J Gastroenterol. 1996;91:366-368. (Retrospective study; 179 patients) 
  88. Runyon BA, Montano AA, Akriviadis EA, et al. The serum-ascites albumin gradient is superior to the exudatetransudate concept in the differential diagnosis of ascites.Ann Intern Med. 1992;117:215-220. (Prospective analysis; 901 paired serum and ascitic fluid samples) 
  89. Gines A, Fernandez-Esparrach G, Monescillo A, et al. Randomized trial comparing albumin, dextran 70, and polygeline in cirrhotic patients with ascites treated by paracentesis.Gastroenterology. 1996;111:1002-1010. (Randomized, controlled trial; 289 patients) 
  90. Sola-Vera J, Minana J, Ricart E, et al. Randomized trial comparing albumin and saline in the prevention of paracentesis- induced circulatory dysfunction in cirrhotic patients with ascites. Hepatology. 2003;37:1147-1153. (Randomized, controlled trial; 72 patients) 
  91. Peltekian KM, Wong F, Liu PP, et al. Cardiovascular, renal, and neurohumoral responses to single large-volume paracentesis in patients with cirrhosis and diuretic-resistant ascites. Am J Gastroenterol. 1997;92:394-399. (Nonrandomized, prospective study; 12 cirrhotic patients with ascites) 
  92. Wang SS, Lu CW, Chao Y, et al. Total paracentesis in nonalcoholic cirrhotics with massive ascites: mid-term effects on systemic and hepatic haemodynamics and renal function.J Gastroenterol Hepatol. 1994;9:592-596. (Nonrandomized, prospective study; 23 patients with massive ascites)
  93. Fernandez J, Navasa M, Garcia-Pagan JC, et al. Effect of intravenous albumin on systemic and hepatic hemodynamics and vasoactive neurohormonal systems in patients with cirrhosis and spontaneous bacterial peritonitis. J Hepatol. 2004;41:384-390. (Nonrandomized cohort study; 12 patients)
  94. Angeli P, Volpin R, Gerunda G, et al. Reversal of type 1 hepatorenal syndrome with the administration of midodrine and octreotide. Hepatology. 1999;29:1690-1697. (Randomized, controlled trial; 13 patients with type 1 HRS)
  95. Duvoux C, Zanditenas D, Hezode C, et al. Effects of noradrenalin and albumin in patients with type I hepatorenal syndrome: a pilot study. Hepatology. 2002;36:374-380. (Nonrandomized, prospective cohort study; 12 patients)
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  99. Sharma P, Kumar A, Sharma BC, et al. An open label, pilot, randomized controlled trial of noradrenaline versus terlipressin in the treatment of type 1 hepatorenal syndrome and predictors of response. Am J Gastroenterol. 2008;103:1689- 1697. (Unblinded randomized, controlled trial; 40 HRS patients)
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  103. Pinzello G, Simonetti RG, Craxi A, et al. Spontaneous bacterial peritonitis: a prospective investigation in predominantly nonalcoholic cirrhotic patients. Hepatology. 1983;3:545-549.(Nonrandomized, prospective sample analysis; 224 inpatients with cirrhosis)
  104. Runyon BA, Antillon MR, Akriviadis EA, et al. Bedside inoculation of blood culture bottles with ascitic fluid is superior to delayed inoculation in the detection of spontaneous bacterial peritonitis. J Clin Microbiol. 1990;28:2811-2812.(Prospective, self-controlled trial; 29 SBP patients)
  105. Akriviadis EA, Runyon BA. Utility of an algorithm in differentiating spontaneous from secondary bacterial peritonitis.Gastroenterology. 1990;98:127-133. (Prospective study; 43 patients with ascitic fluid infection)
  106. Wu SS, Lin OS, Chen YY, et al. Ascitic fluid carcinoembryonic antigen and alkaline phosphatase levels for the differentiation of primary from secondary bacterial peritonitis with intestinal perforation. J Hepatol. 2001;34:215-221. (Prospective study; 135 patients with ascites)
  107. Koulaouzidis A, Leontiadis GI, Abdullah M, et al. Leucocyte esterase reagent strips for the diagnosis of spontaneous bacterial peritonitis: a systematic review. Eur J Gastroenterol Hepatol. 2008;20:1055-1060. (Systematic review of 17 prospective trials)
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  109. Felisart J, Rimola A, Arroyo V, et al. Cefotaxime is more effective than is ampicillin-tobramycin in cirrhotics with severe infections. Hepatology. 1985;5:457-462. (Randomized, controlled trial; 73 cirrhotic patients with severe bacterial infection)
  110. Soares-Weiser K, Brezis M, Leibovici L. Antibiotics for spontaneous bacterial peritonitis in cirrhotics. Cochrane Database Syst Rev. 2001:CD002232. (Meta-analysis of 9 randomized, controlled trials; 694 patients)
  111. Sort P, Navasa M, Arroyo V, et al. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N Engl J Med. 1999;341:403-409. (Randomized, controlled trial; 126 patients)
  112. Stollman NH, Putcha RV, Neustater BR, et al. The uncleared fundal pool in acute upper gastrointestinal bleeding: implications and outcomes. Gastrointest Endosc. 1997;46:324-327.(Retrospective cohort study; 484 patients)
  113. Coffin B, Pocard M, Panis Y, et al. Erythromycin improves the quality of EGD in patients with acute upper GI bleeding: a randomized controlled study. Gastrointest Endosc. 2002;56:174-179. (Randomized, controlled trial; 41 patients)
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  115. Marti-Carvajal AJ, Salanti G, Marti-Carvajal PI. Human recombinant activated factor VII for upper gastrointestinal bleeding in patients with liver diseases. Cochrane Database Syst Rev. 2007:CD004887. (Systematic review, 1 randomized, controlled trial; 242 patients)
  116. Bosch J, Thabut D, Bendtsen F, et al. Recombinant factor VIIa for upper gastrointestinal bleeding in patients with cirrhosis: a randomized, double-blind trial. Gastroenterology. 2004;127:1123-1130. (Randomized, controlled trial; 245 cirrhotic patients)
  117. Gotzsche PC, Hrobjartsson A. Somatostatin analogues for acute bleeding oesophageal varices. Cochrane Database Syst Rev. 2008:CD000193. (Meta-analysis of 21 trials; 2588 patients) 
  118. D'Amico G, Pietrosi G, Tarantino I, et al. Emergency sclerotherapy versus vasoactive drugs for variceal bleeding in cirrhosis: a Cochrane meta-analysis. Gastroenterology. 2003;124:1277-1291. (Meta-analysis of 15 randomized, controlled trials)
  119. Banares R, Albillos A, Rincon D, et al. Endoscopic treatment versus endoscopic plus pharmacologic treatment for acute variceal bleeding: a meta-analysis. Hepatology. 2002;35:609- 615. (Meta-analysis of 8 randomized, controlled trials; 939 patients)
  120. Soares-Weiser K, Brezis M, Tur-Kaspa R, et al. Antibiotic prophylaxis for cirrhotic patients with gastrointestinal bleeding. Cochrane Database Syst Rev. 2002:CD002907. (Meta-analysis of 8 randomized, controlled trials; 864 patients)
  121. Fernandez J, Ruiz del Arbol L, Gomez C, et al. Norfloxacin vs ceftriaxone in the prophylaxis of infections in patients with advanced cirrhosis and hemorrhage. Gastroenterology. 2006;131:1049-1056; quiz 1285. (Randomized, controlled trial; 111 advanced cirrhotic patients with GI hemorrhage)
  122. Bar-Joseph G, Guilburd Y, Tamir A, Guilburd JN. Effectiveness of ketamine in decreasing intracranial pressure in children with intracranial hypertension. J Neurosurg Pediatr. 2009;4:40-46. (Prospective cohort study; 82 pediatric patients)
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  125. Wijdicks EF, Nyberg SL. Propofol to control intracranial pressure in fulminant hepatic failure. Transplant Proc. 2002;34:1220-1222. (Prospective cohort study; 7 liver failure patients)
  126. Knox TA, Olans LB. Liver disease in pregnancy. N Engl J Med. 1996;335:569-576. (Review article) 
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  128. Ockner SA, Brunt EM, Cohn SM, et al. Fulminant hepatic failure caused by acute fatty liver of pregnancy treated by orthotopic liver transplantation. Hepatology. 1990;11:59-64.(Case report)
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Publication Information

Caitlin Bailey; H. Gene Hern, Jr.

Publication Date

April 2, 2010

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