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Clinical Gastroenterology 2016
October 03-05, 2016
Volume 6, Issue 6(Suppl) J Gastrointest Dig Syst
ISSN:2161-069X JGDS, an open access journal
conferenceseries .com
October 03-05, 2016 Toronto, Canada
8th International Conference on
Clinical Gastroenterology & Hepatology
J Gastrointest Dig Syst 2016, 6:6(Suppl)
Predictors of mortality in patients with liver cirrhosis admitted at Intensive Care Unit at Cardinal
Santos Medical Center, Philippines: A retrospective cross-sectional analytical study
Sato Kenji M, Agcaoli Jennielyn C and Payawal Diana A
Cardinal Santos Medical Center, Philippines
C irrhotic patients who need critical care support show high morbidity and mortality rates compared with other critically
ill patients. Their prognosis is influenced by both the severity of the underlying hepatic disease and the worsening of
extra-hepatic organ function. Patients with cirrhosis are admitted at the Intensive Care Unit (ICU) for complications of portal
hypertension culminating in multiple organ failure in a large portion of patients. The objective of the study is to identify
predictors of mortality of patients with cirrhosis admitted to ICU of Cardinal Santos Medical Center and to compare these
predictors to that established liver specific (Child-Pugh Score, MELD and MELD-Na) prognostic models. A total of 51 cirrhotic
patients were admitted from June 1, 2009 to June 30, 2015. The results are presented as Mean  Standard Deviations and
confidence intervals of 95% for quantitative variables and as percentages for categorical variables. It was found that hepatitis B
is the most common cause of cirrhosis. Although Child-Pugh score indicates the severity of underlying liver disease, it cannot
be considered as the best tool for predicting mortality. Among patients admitted at the ICU, encephalopathy is a complication
involving low survival. Among the clinical parameters, the use of mechanical ventilator; the need for inotropic support; and the
need for renal replacement therapy are associated with increased mortality. Among the laboratory parameters, lower venous
pH and bicarbonate values are significantly associated with mortality. Hence, the prognosis for cirrhotic patients admitted to
the ICU is poor.
Gastroesophageal reflux disease (GERD) care pathway: Indian expert panel recommendations
Varsha Khatry
Pfizer Limited, Mumbai, India
Gastroesophageal reflux disease (GERD) is defined as symptoms or complications resulting from the reflux of gastric contents
repeatedly into the esophagus or beyond (into the oral cavity, larynx or lung). GERD is one of the most common diseases
encountered not just by gastroenterologists but by primary-care physicians, consulting physicians, and other specialists. This
presentation presents consensus recommendations to identify the best therapeutic options in GERD which were collectively
formulated by an expert panel consisting of experts from various disciplines (gastroenterologists, physicians, cardiologists
and diabetologists) across India. The expert panel provided recommendations for various aspects of GERD including the
importance of lifestyle modifications (weight loss, smoking cessation, limited intake of tea, coffee, restricted fatty and spicy
food intake, avoiding larger meals and avoiding meals at late night); recommendations for appropriate use of PPIs in the
treatment of GERD (consumption of PPIs 30-60 min prior to breakfast, maintaining treatment for a period of 8 weeks). The
panel suggests adequate use of step up and step down of PPIs to avoid over use of the medication in patients. Adequate duration
of treatment (8 weeks in most cases) is important. Adequate treatment of GERD should be able to achieve this objective, but no
pharmaceutical agent can fully correct the multiple mechanisms involved, like motor dysfunction, weak sphincter, acid pocket,
night-time regurgitation responsible for acid reflux into the esophagus. Acid suppression remains the most effective way to
relieve symptoms and to promote healing of esophagitis in patients with GERD. Addition of proper adjuvant therapy may be
required depending on pathogenesis.