Critical care management of acute liver failure.
Indian J Gastroenterol
; 43(2): 361-376, 2024 Apr.
Article
in En
| MEDLINE
| ID: mdl-38578565
ABSTRACT
The management of acute liver failure (ALF) in modern hepatology intensive care units (ICU) has improved patient outcomes. Critical care management of hepatic encephalopathy, cerebral edema, fluid and electrolytes; prevention of infections and organ support are central to improved outcomes of ALF. In particular, the pathogenesis of encephalopathy is multifactorial, with ammonia, elevated intra-cranial pressure and systemic inflammation playing a central role. Although ALF remains associated with high mortality, the availability of supportive care, including organ failure support such as plasma exchange, timely mechanical ventilation or continuous renal replacement therapy, either conservatively manages patients with ALF or offers bridging therapy until liver transplantation. Thus, appropriate critical care management has improved the likelihood of patient recovery in ALF. ICU care interventions such as monitoring of cerebral edema, fluid status assessment and interventions for sepsis prevention, nutritional support and management of electrolytes can salvage a substantial proportion of patients. In this review, we discuss the key aspects of critical care management of ALF.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Brain Edema
/
Hepatic Encephalopathy
/
Liver Failure, Acute
/
Critical Care
Limits:
Humans
Language:
En
Journal:
Indian J Gastroenterol
Journal subject:
GASTROENTEROLOGIA
Year:
2024
Document type:
Article
Affiliation country: