H2-Receptor Antagonists and Antacids in the Prevention of Acute Gastrointestinal Hæmorrhage in Fulminant Hepatic Failure

Macdougall, B.R.D.; Bailey, R.J.; Williams, Roger

doi:10.1016/s0140-6736(77)92055-4

Cited by 221 publications

(95 citation statements)

References 12 publications

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“…1,21 This involved continuous intravenous dextrose infusion to prevent hypoglycemia; broadspectrum prophylactic antimicrobials to prevent bacterial and fungal infections, [22][23][24][25] and ranitidine and/or sucralfate to prevent acute gastrointestinal bleeding. 26 Children were admitted to the pediatric intensive care unit if they developed encephalopathy grade Ͼ2, became hypoxic, or needed sedation. 2 Hemofiltration was commenced if the child developed oliguria or renal failure.…”

Section: Methodsmentioning

confidence: 99%

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Safety and efficacy of N-acetylcysteine in children with non-acetaminophen-induced acute liver failure

et al. 2007

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Acute liver failure (ALF) carries a high mortality in children. N-acetylcysteine (NAC), an antioxidant agent that replenishes mitochondrial and cytosolic glutathione stores, has been used in the treatment of late acetaminophen-induced ALF and non-acetaminophen-induced ALF. In our unit, NAC was introduced as additional treatment for non-acetaminophen-induced ALF in 1995. The aim of this study was to evaluate the safety and efficacy of NAC in children with ALF not caused by acetaminophen poisoning. A retrospective review of medical records of 170 children presenting with nonacetaminopheninduced ALF between 1989 and 2004 was undertaken. ALF was defined as either international normalized ratio of prothrombin time (INR) Ͼ 2 and abnormal liver function or INR Ͼ1.5 with encephalopathy and abnormal liver function. Children were divided into the following groups: Group 1 (1989)(1990)(1991)(1992)(1993)(1994), standard care (n ϭ 59; 34 [58%] male; median age 2.03 yr, range 0.003-15.8 yr); and Group 2 (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004), standard care and NAC administration (n ϭ 111; 57 [51%] male; median age 3.51 yr, range 0.005-17.4 yr). NAC was administered as a continuous infusion (100 mg/kg/24 hours) until INR Ͻ 1.4, death, or liver transplantation (LT). The median duration of NAC administration in Group 2 was 5 (range, 1-77) days. Complications were noted in 8 (10.8%) children: rash in 3, arrhythmia in 3, and dizziness and peripheral edema in 1. One child had an allergic reaction (bronchospasm) and NAC was stopped. A total of 41 (71%) children in Group 1 vs. 85 (77%) in Group 2 required admission to intensive care, P ϭ not significant (ns). The length of intensive care stay was 6 (range, 1-58) days in Group 1 vs. 5 (range, 1-68) days in Group 2, P ϭ ns and length of hospital stay was 25 (range, 1-264) days vs. 19 (range, 1-201) days, P ϭ 0.05. The 10-yr actuarial survival was 50% in Group 1 compared to 75% in Group 2, P ϭ 0.009. Survival with native liver occurred in 13 (22%) in Group 1 vs. 48 (43%) in Group 2, P ϭ 0.005; 15 (25%) in Group 1 died without transplant vs. 21 (19%) in Group 2, P ϭ ns; and LT was performed in 32 (54%) vs. 42 (38%), P ϭ ns. Death after transplantation occurred in 15 (39%) in Group 1 vs. 8 (16%) in Group 2, P ϭ 0.02. In conclusion, NAC is safe in non-acetaminophen-induced ALF. In this retrospective study NAC was associated with a shorter length of hospital stay, higher incidence of native liver recovery without transplantation, and better survival after transplantation. Liver Transpl 14: [25][26][27][28][29][30] 2008 See Editorial on Page 7Acute liver failure (ALF) in children is a rare but often fatal condition without liver transplantation (LT). [1][2][3] Multiorgan dysfunction in ALF is believed to derive from oxidative stress due to reactive oxygen species and reactive nitrogen species 4 and from immunological injury mediated by cytokines. 5-8 N-acetylcysteine (NAC) is a thiol-containing agent that scavenges free oxygen radicals and replenishes cellular mitochon...

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Section: Methodsmentioning

confidence: 99%

“…In this retrospective study NAC was associated with a shorter length of hospital stay, higher incidence of native liver recovery without transplantation, and better survival after transplantation. Liver Transpl 14: [25][26][27][28][29][30] 2008 …”

mentioning

confidence: 99%

Safety and efficacy of N-acetylcysteine in children with non-acetaminophen-induced acute liver failure

et al. 2007

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“…In the prophylaxis and treatment of acute gastroduodenal lesions, however, the advantages of cimetidine have only been suggested by the results of animal experiments [14, 86, I00], clinical case reports [6,24,75,94], retrospective trials and prospective trials using either historical controls [13,52,82,107] or patients from highly selected groups [25,26,30,42,76,112]. Since histamine H2-receptors in acid secretion [9] and microcirculation [41] and histamine release from intra-and extragastric cellular stores [64,65,105,106] are likely to play an important role in the pathogenesis of acute as well as chronic gastroduodenal ulceration it could be expected that therapy using H2-receptor antagonism could offer clinical advantages to patients likely to or developing stress ulcerations.…”

Section: Abstract: Stress Ulcerationmentioning

confidence: 99%

“…Significant reactions reasonable attributable to the drug (decision of the executive group) was preferred since cimetidine being provided for usually lifethreatening conditions was already theoretically favoured for stress ulcer prophylaxis [76]. The new design had to be worked out separately for the 4 subgroups and the trial was not longer accepted as donNe-blind, but only as single-blind (at least for the academic staff).…”

Section: July 1976mentioning

confidence: 99%

“…In renal failure (creatinium more than 2.5 mg/dl corresp, to 221 nmol/1) the dose was reduced to 2 x 200 rag/day (8 a.m. and 8 p.m.) which kept the blood level as high as 1.2 g/day in normal conditions [16]. The usual dose and route of application were chosen considering both efficacy [1,76] and pharmacokinetics [39].…”

Section: Groups Treated By Cimetidine and Regimen Of Drug Administratmentioning

confidence: 99%

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Histamine and stress ulcer: New components in organizing a sequential trial on cimetidine prophylaxis in seriously Ill patients and definition of a special group at risk (severe polytrauma)

et al. 1980

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Cimetidine. H2-receptor blockade in gastrointestinal disease

Schlippert¹

1978

Archives of Internal Medicine

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H2-Receptor Antagonists and Antacids in the Prevention of Acute Gastrointestinal Hæmorrhage in Fulminant Hepatic Failure

Cited by 221 publications

References 12 publications

Safety and efficacy of N-acetylcysteine in children with non-acetaminophen-induced acute liver failure

Safety and efficacy of N-acetylcysteine in children with non-acetaminophen-induced acute liver failure

Histamine and stress ulcer: New components in organizing a sequential trial on cimetidine prophylaxis in seriously Ill patients and definition of a special group at risk (severe polytrauma)

Cimetidine. H2-receptor blockade in gastrointestinal disease

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