Indiana University Intensive Care Unit Hepatology Registry (ICU-Registry): A Prospective Observational Study

Despite gaining knowledge on the probable pathophysiology driving organ dysfunction in acute on chronic liver failure (ACLF), there is little prospective data on the clinical course of organ dysfunction (before, during, and after) associated with ACLF in the ICU setting. Isolated clinical characteristics in critically ill cirrhotic patients such as the need for mechanical ventilation and acute kidney injury (AKI) have been evaluated but are limited by their retrospective design and lack of longitudinal granularity. As a result, there have not been any prospective trials to evaluate if changing certain parameters during a patient’s ICU stay (i.e. mean arterial pressure parameters, earlier continuous renal replacement therapy, types of ventilator modes, etc.) impacts short or long-term outcomes and the natural history of organ dysfunction, particularly the renal and cardiovascular system. Consequently, there have been limited evidence-based recommendations regarding management for this high risk patient population.  Moreover, there is limited granular data regarding re-admission rates to the ICU, quality of life indices post ICU stay, and on intermediate and long term mortality.  Thus, it is our long-term goal to understand these aforementioned aspects to eventually translate our findings into new management paradigms.