TABLE 3.
Patient characteristics of the 4 individuals developing SC‐CIP (sclerosing cholangitis in critically ill patients)
| Characteristics | Patient 1 | Patient 2 | Patient 3 | Patient 4 |
|---|---|---|---|---|
| Age, years | 59 | 67 | 54 | 64 |
| Sex | M | M | F | M |
| BMI, kg/m2 | 28.0 | 24.0 | 24.7 | 24.7 |
| Comorbidities | ||||
| Diabetes mellitus | Yes | Yes | Yes | No |
| Adipositas | No | No | No | No |
| Chronic liver disease | No | No | No | No |
| Chronic lung disease | No | No | No | No |
| Chronic kidney disease | No | No | No | No |
| Severity Scores | ||||
| SOFA (ICU admission) | 15 | 12 | 7 | 14 |
| SAPS II | 72 | 45 | 28 | 70 |
| LFT at admission | ||||
| AST, × ULN | 0.96 | 0.62 | 0.77 | 0.92 |
| ALT, × ULN | 0.54 | 0.36 | 0.86 | 0.62 |
| GGT, × ULN | 0.60 | 0.25 | 1.55 | 0.62 |
| ALP, × ULN | 0.25 | 0.58 | 0.58 | 0.39 |
| Total bilirubin, × ULN | 0.38 | 0.24 | 0.29 | 0.57 |
| INR | 1.0 | 1.0 | 1.0 | 1.0 |
| Peak LFT | ||||
| AST, × ULN | 28.70 | 13.44 | 9.26 | 33.14 |
| ALT, × ULN | 19.84 | 7.26 | 12.37 | 23.04 |
| GGT, × ULN | 55.97 | 28.15 | 85.13 | 50.52 |
| ALP, × ULN | 21.26 | 18.81 | 17.30 | 12.85 |
| Total bilirubin, × ULN | 26.05 | 8.05 | 3.81 | 17.43 |
| INR | 1.0 | 1.0 | 1.0 | 2.2 |
| Time form ICU admission to first rise of ALP (days) | 20 | 10 | 10 | 6 |
| Time from ICU admission to diagnosis of SSC (days) | 70 | 74 | 153 | 75 |
| Treatments at ICU | ||||
| Vasopressors | Yes | Yes | Yes | Yes |
| Mechanical ventilation | Yes (43 days) | Yes (20 days) | Yes (55 days) | Yes (28 days) |
| Proning | Yes (10 days) | Yes (6 days) | Yes (10 days) | Yes (11 days) |
| Nitric Oxide | No | No | Yes | Yes |
| ECMO | No | Yes | Yes | No |
| RRT | Yes | Yes | No | Yes |
| Parenteral nutrition | Yes | No | No | No |
| Ketamine Sedation | Yes (16 days) | Yes (5 days) | Yes (23 days) | Yes (14 days) |
| Anticoagulation | Heparin | Heparin | Heparin | Heparin |
| Outcomes | ||||
| Nosocomial Infection | Yes | Yes | No | No |
| Septic shock | No | No | Yes | Yes |
| AKI | Yes | Yes | No | Yes |
| ARDS | Yes | Yes | Yes | Yes |
| ICU days | 51 | 98 | 78 | 88 |
| ICU mortality | No | No | No | No |
| Listed for liver transplant | Yes | n.a. | No | n.a. |
| COVID‐19‐specific medication | Hydroxychloroquine | Hydroxychloroquine | Hydroxychloroquine, Lopinavir / Ritonavir | None |
| Other Medication | ||||
| UDCA | Yes | Yes | Yes | Yes |
| Steroids | No | No | No | No |
| MRCP with typical findings of SC‐CIP | Yes | Yes | Yes | Yes |
| Follow up after hospital discharge | Last follow up, 7 month 3 weeks after discharge from ICU; cirrhosis Child B, MELD 17, deeply jaundiced (Bilirubin 217 ymol/l) and on the transplant waiting list | Exitus letalis 55 days after ICU discharge (80 days after SSC diagnosis) as a result of respiratory failure (pulmonary infection) | Last follow up, 9 month and 2 weeks after discharge from ICU; compensated liver function, persistently marked increased ALP and GGT | Exitus letalis 14 days after ICU discharge (26 days after SSC diagnosis) caused by sepsis / pulmonary infection |
Abbreviation: AKI, acute kidney injury; ALT, alanine aminotransferase; ALP, alkaline phosphatase, AST, aspartate aminotransferase; ARDS, acute respiratory distress syndrome; BMI, body mass index; GGT; gamma‐glutamyl transferase; ICU, intensive care unit; INR, international normalized ratio; LFT, liver function tests; MRCP, magnetic resonance cholangiopancreatography; RRT, renal replacement therapy; SAPS II Score, Simplified Acute Physiology Score; SOFA Score, Sequential Organ Failure Assessment Score; SSC, secondary sclerosing cholangitis; UDCA, Ursodeoxycholic acid; ULN, upper limit of normal.