8 research outputs found

    MOESM1 of Acid–base status and its clinical implications in critically ill patients with cirrhosis, acute-on-chronic liver failure and without liver disease

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    Additional file 1: Figure S1. Acid–base disturbances and their relation to severity of disease in critically ill patients with and without liver cirrhosis. Overall following parameter differed significantly between cirrhosis and non-cirrhosis patients (Wilcoxon’s signed-rank test): BE (p < 0.01), lactate (p < 0.001), BEUMA (p < 0.05), SIG (p < 0.01) and PaCO2 (p < 0.01), but not pH (p = 0.624). *p values between regression slopes were obtained from linear regression models with interaction term

    MOESM2 of Acid–base status and its clinical implications in critically ill patients with cirrhosis, acute-on-chronic liver failure and without liver disease

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    Additional file 2: Figure S2. Base excess attributable to unmeasured anions (BEUMA) and strong ion gap (SIG) are associated with acute kidney injury in critically ill patients with and without cirrhosis. BEUMA (p < 0.05) and SIG (p < 0.01) differed significantly between patients with and without cirrhosis, but correlated significantly with stage of acute kidney injury in both groups (p < 0.001). The association of BEUMA and SIG, respectively, with acute kidney injury did not differ between patients with and without cirrhosis (p = 0.994 and 0.824

    Augmentation therapy for severe alpha-1 antitrypsin deficiency improves survival and is decoupled from spirometric decline - a multinational registry analysis.

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    Rationale: Intravenous plasma-purified alpha-1 antitrypsin (IV-AAT) has been used as therapy for alpha-1 antitrypsin deficiency (AATD) since 1987. Previous trials (RAPID and RAPID-OLE) demonstrated efficacy in preserving computed tomography of lung density but no effect on FEV1. This observational study evaluated 615 people with severe AATD from three countries with socialized health care (Ireland, Switzerland, and Austria), where access to standard medical care was equal but access to IV-AAT was not. Objectives: To assess the real-world longitudinal effects of IV-AAT. Methods: Pulmonary function and mortality data were utilized to perform longitudinal analyses on registry participants with severe AATD. Measurements and Main Results: IV-AAT confers a survival benefit in severe AATD (P Conclusions: This real-world study demonstrates a survival advantage from IV-AAT. This improved survival is largely decoupled from FEV1 decline. The observation that patients with severe AATD fall into two major phenotypes has implications for clinical trial design where FEV1 is a primary endpoint. Recruits into trials are typically older lung indexes entering the plateau phase and, therefore, unlikely to show spirometric benefits. IV-AAT attenuates spirometric decline in lung indexes in GOLD stage 2, a spirometric group commonly outside current IV-AAT commencement recommendations. </p
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