• Filipe S Cardoso, Rui Pereira, Ana Laranjo, Veronica Gamelas, Luís Bagulho, Nuno Germano, and Constantine J Karvellas.
• Divisions of Gastroenterology and Intensive Care, Curry Cabral Hospital, Nova Medical School, Lisbon, Portugal. Electronic address: filipe_sousacardoso@hotmail.com.
• J Crit Care. 2021 Jun 1; 63: 238-242.

PurposeWe aimed to study the effect of FB in the outcomes of critically-ill patients with cirrhosis.MaterialsRetrospective analysis of all adult consecutive admissions of patients with cirrhosis and organ failures to the Intensive Care Unit (ICU) at Curry Cabral Hospital (Lisbon, Portugal) and University of Alberta Hospital (Edmonton, Canada) on 08/2013-08/2017. Primary exposure was FB at 3 and 7 days post ICU admission. Primary endpoint was hospital mortality.ResultsAmongst 333 patients, median age was 56 years and 67.6% were men. Median MELD, APACHEII, CLIF-SOFA, and CLIF-C-ACLF scores on ICU admission were 27, 28, 14, and 54, respectively. ICU and hospital mortality rates were 33.0% and 49.2%, respectively. While median FB at 3 days post ICU admission (+5.46 l vs. +6.62 l; P = 0.74) was not associated with hospital mortality, higher median FB at 7 days post ICU admission (+13.50 l vs. +6.90 l; P = 0.036) was associated with higher hospital mortality. This association remained significant (OR 95%CI = 1.04 [1.01;1.07] per each l) after adjustment for confounders (age, ascites, infection, lactate, and number of organ failures).ConclusionsFB may be a therapeutic target that helps to improve the outcomes of patients with acute-on-chronic liver failure. This data may inform future clinical trials.Copyright © 2020 Elsevier Inc. All rights reserved.

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