Major cancer hepatectomy exposes patients to postoperative liver insufficiency. 1 Allard M.A. Adam R. Bucur P.O. et al. Posthepatectomy portal vein pressure predicts liver failure and mortality after major liver resection on noncirrhotic liver. Ann Surg. 2013; 258: 822-829 Crossref PubMed Scopus (101) Google Scholar This risk is dependent on the volume and function of the future liver remnant (FLR). In this situation, rapid expansion of the FLR can be achieved with portal venous embolization (PVE) of the contralateral liver segments. Usually, PVE is performed 4–8 weeks prior to the hepatectomy to allow the growth of the nonembolized liver lobes. 2 Narula N. Aloia T.A. Portal vein embolization in extended liver resection. Langenbecks Arch Surg. 2017; 402: 727-735 Crossref PubMed Scopus (14) Google Scholar Preconditioning by portal vein embolization modulates hepatic hemodynamics and improves liver function in pigs with extended hepatectomySurgeryVol. 161Issue 6PreviewPortal vein embolization is performed weeks before extended hepatic resections to increase the future liver remnant and prevent posthepatectomy liver failure. Portal vein embolization performed closer to the operation also could be protective, but worsening of portal hyper-perfusion is a major concern. We determined the hepatic hemodynamic effects of a portal vein embolization performed 24 hours prior to hepatic operation. Full-Text PDF

To date, no study has been specifically designed to identify determinants of death in neutropenic cancer patients presenting with acute respiratory distress syndrome (ARDS). The aim of this study was to identify early predictive factors of 28-day mortality in these patients. Factors associated with 28-day mortality during intensive care unit (ICU) stay were also described.70 consecutive cancer patients with ARDS and neutropenia were prospectively analysed over a 6-yr period.Mortality at 28 days was 63%. Factors independently associated with good prognosis were: lobar ARDS (OR 0.10, 95% CI 0.02–0.48), use of initial antibiotic treatment active on difficult to treat bacteria (ticarcillin-resistantPseudomonas aeruginosa,Stenotrophomonas maltophiliaor extended-spectrum β-lactamase-producing strains) (OR 0.08, 95% CI 0.02–0.33) and first-line chemotherapy (OR 0.08, 95% CI 0.02–0.37). During the ICU stay, mortality was associated with the markers of organ dysfunctions, the absence of neutropenia recovery and the use of vasopressors. During the first 3 weeks, the conditional probability of discharge alive from ICU did not decrease.At ICU admission, first-line chemotherapy, lobar ARDS and antibiotic treatment active on difficult-to-treat bacteria were associated with survival. During ICU stay, mortality was associated with organ dysfunctions and use of vasopressors. Most survivors have an ICU stay of >3 weeks.