Improving survival of acute-on-chronic liver failure patients complicated with invasive pulmonary aspergillosis

Abstract The mortality of acute-on-chronic liver failure (ACLF) patients complicated with invasive pulmonary aspergillosis (IPA) was extremely high. We aimed to explore prognostic value of the Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) lung score and to establish an optima...

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Autores principales:	Jie Gao, Qing Zhang, Yuankui Wu, Ying Li, Tingting Qi, Congyan Zhu, Sijia Liu, Ruoxi Yu, Qinjun He, Weiqun Wen, Fuyuan Zhou, Yongpeng Chen, Jinjun Chen, Jinlin Hou
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c8ccf89da1c648b5aafb26be15e2525c
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spelling	oai:doaj.org-article:c8ccf89da1c648b5aafb26be15e2525c2021-12-02T15:08:57ZImproving survival of acute-on-chronic liver failure patients complicated with invasive pulmonary aspergillosis10.1038/s41598-018-19320-22045-2322https://doaj.org/article/c8ccf89da1c648b5aafb26be15e2525c2018-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-19320-2https://doaj.org/toc/2045-2322Abstract The mortality of acute-on-chronic liver failure (ACLF) patients complicated with invasive pulmonary aspergillosis (IPA) was extremely high. We aimed to explore prognostic value of the Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) lung score and to establish an optimal voriconazole regimen for ACLF patients complicated with IPA. We retrospectively screened hospitalized ACLF patients in our hospital from July 2011 to April 2016, from which 20 probable IPA cases were diagnosed. Along with onsets of IPA, deteriorated diseases severity, especially lung conditions were found in those 20 ACLF patients. It was found that IPA patients with CLIF-SOFA lung score <2 had better 28-day survival than those with lung score >1 (11/13 vs 0/7, p < 0.001). Based on plasma voriconazole concentration measurement, an optimal voriconazole regimen (loading doses: 0.2 g twice daily; maintenance doses, 0.1 g once daily) was established, which resulted in rational trough plasma drug concentrations (1–5 μg/mL), good clinical outcomes (90-day survival rate of 6/8) and no observed adverse events. In conclusion, CLIF-SOFA lung score >1 was able to identify ACLF patients complicated with IPA encountering much higher 28-day mortality. An optimal voriconazole regimen was safe and effective in our ACLF patients complicated with IPA.Jie GaoQing ZhangYuankui WuYing LiTingting QiCongyan ZhuSijia LiuRuoxi YuQinjun HeWeiqun WenFuyuan ZhouYongpeng ChenJinjun ChenJinlin HouNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-8 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jie Gao Qing Zhang Yuankui Wu Ying Li Tingting Qi Congyan Zhu Sijia Liu Ruoxi Yu Qinjun He Weiqun Wen Fuyuan Zhou Yongpeng Chen Jinjun Chen Jinlin Hou Improving survival of acute-on-chronic liver failure patients complicated with invasive pulmonary aspergillosis
description	Abstract The mortality of acute-on-chronic liver failure (ACLF) patients complicated with invasive pulmonary aspergillosis (IPA) was extremely high. We aimed to explore prognostic value of the Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) lung score and to establish an optimal voriconazole regimen for ACLF patients complicated with IPA. We retrospectively screened hospitalized ACLF patients in our hospital from July 2011 to April 2016, from which 20 probable IPA cases were diagnosed. Along with onsets of IPA, deteriorated diseases severity, especially lung conditions were found in those 20 ACLF patients. It was found that IPA patients with CLIF-SOFA lung score <2 had better 28-day survival than those with lung score >1 (11/13 vs 0/7, p < 0.001). Based on plasma voriconazole concentration measurement, an optimal voriconazole regimen (loading doses: 0.2 g twice daily; maintenance doses, 0.1 g once daily) was established, which resulted in rational trough plasma drug concentrations (1–5 μg/mL), good clinical outcomes (90-day survival rate of 6/8) and no observed adverse events. In conclusion, CLIF-SOFA lung score >1 was able to identify ACLF patients complicated with IPA encountering much higher 28-day mortality. An optimal voriconazole regimen was safe and effective in our ACLF patients complicated with IPA.
format	article
author	Jie Gao Qing Zhang Yuankui Wu Ying Li Tingting Qi Congyan Zhu Sijia Liu Ruoxi Yu Qinjun He Weiqun Wen Fuyuan Zhou Yongpeng Chen Jinjun Chen Jinlin Hou
author_facet	Jie Gao Qing Zhang Yuankui Wu Ying Li Tingting Qi Congyan Zhu Sijia Liu Ruoxi Yu Qinjun He Weiqun Wen Fuyuan Zhou Yongpeng Chen Jinjun Chen Jinlin Hou
author_sort	Jie Gao
title	Improving survival of acute-on-chronic liver failure patients complicated with invasive pulmonary aspergillosis
title_short	Improving survival of acute-on-chronic liver failure patients complicated with invasive pulmonary aspergillosis
title_full	Improving survival of acute-on-chronic liver failure patients complicated with invasive pulmonary aspergillosis
title_fullStr	Improving survival of acute-on-chronic liver failure patients complicated with invasive pulmonary aspergillosis
title_full_unstemmed	Improving survival of acute-on-chronic liver failure patients complicated with invasive pulmonary aspergillosis
title_sort	improving survival of acute-on-chronic liver failure patients complicated with invasive pulmonary aspergillosis
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/c8ccf89da1c648b5aafb26be15e2525c
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Improving survival of acute-on-chronic liver failure patients complicated with invasive pulmonary aspergillosis

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