Sepsis in liver failure patients:Diagnostic challenges and recent advancements  

作　　者：Ramesh Kumar Abhishek Kumar Sudhir Kumar 

机构地区：[1]Department of Gastroenterology,All India Institute of Medical Sciences,Patna 801507,Bihar,India

出　　处：《World Journal of Critical Care Medicine》2025年第2期7-17,共11页世界重症医学杂志(英文)

摘　　要：Acute liver failure(ALF)and acute-on-chronic LF(ACLF)are prevalent hepatic emergencies characterized by an increased susceptibility to bacterial infections(BI),despite significant systemic inflammation.Literature indicates that 30%–80%of ALF patients and 55%–81%of ACLF patients develop BI,attributed to immu-nological dysregulation.Bacterial sepsis in these patients is associated with adverse clinical outcomes,including prolonged hospitalization and increased mortality.Early detection of bacterial sepsis is critical;however,distinguishing between sterile systemic inflammation and sepsis poses a significant challenge due to the overlapping clinical presentations of LF and sepsis.Conventional sepsis biomarkers,such as procalcitonin and C-reactive protein,have shown limited utility in LF patients due to inconsistent results.In contrast,novel biomarkers like presepsin and sTREM-1 have demonstrated promising discrim-inatory performance in this population,pending further validation.Moreover,emerging research highlights the potential of machine learning-based approaches to enhance sepsis detection and characterization.Although preliminary findings are encouraging,further studies are necessary to validate these results across diverse patient cohorts,including those with LF.This article provides a compre-hensive review of the magnitude,impact,and diagnostic challenges associated with BI in LF patients,focusing on novel advancements in early sepsis detection and characterization.

关 键 词：Liver failure SEPSIS Bacterial infection Acute liver failure Acute-on-chronic liver failure 

分 类 号：R57[医药卫生—消化系统]