Structured approach to treat patients with acute liver failure: A hepatic emergency.

Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine
Ramesh Kumar, Vikram Bhatia

Abstract

Acute liver failure (ALF) is a condition of acute hepatic emergency where rapid deterioration of hepatocyte function leads to hepatic encephalopathy, coagulopathy, cerebral edema (CE), infection and multi-organ dysfunction syndrome resulting in a high mortality rate. Urgent liver transplantation is the standard of care for most of these patients in Western countries. However, in India, access to liver transplantation is severely limited and, hence, the management is largely based on intensive medical care. With earlier recognition of disease, better understanding of pathophysiology and improved intensive care, ALF patients have shown a significant improvement in spontaneous survival. An evidence base for practice for supportive care is still lacking; however, intensive organ support as well as control of infection and CE are likely to be key to the successful outcome in this acute and potentially reversible condition without any sequel. A structured approach to decision making about intensive care is important in each case. Unlike in Western countries where acetamenophen is the most common cause of ALF, the role of a specific agent, such as N-acetylcysteine, is limited in India. Ammonia-lowering therapy is still in an evolving ...Continue Reading

References

Feb 1, 1978·Journal of Neurosurgery·L F MarshallH M Shapiro
Jul 1, 1992·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·S D LidofskyJ R Lake
Aug 15, 1991·The New England Journal of Medicine·A S BasileP Skolnick
Nov 1, 1991·Seminars in Liver Disease·S J Muñoz
Sep 1, 1991·Gut·R D HughesA E Gimson
May 1, 1991·Brain Research Bulletin·P ValeriL Romanelli
Jan 1, 1990·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·A DavenportA M Davison
Sep 1, 1989·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·A ForbesR Williams
Oct 1, 1988·Journal of Biosocial Science·R E WrightH E Joshi
Nov 1, 1988·Gastrointestinal Endoscopy·R A Wright
Feb 1, 1986·Journal of Applied Physiology·M R PinskyM Klain
Nov 1, 1986·Journal of Neurosurgery·M J Rosner, I B Coley
May 1, 1986·Anesthesiology·M YanoT Otsuka
Jul 31, 1993·Lancet·J G O'GradyR Williams
Jun 1, 1994·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·J A WendonR Williams
Feb 1, 1993·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·N RolandoR Williams
Apr 1, 1996·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·O P RosaegJ P MacLeod
Nov 1, 1996·Seminars in Liver Disease·N RolandoR Williams
Nov 1, 1996·Seminars in Liver Disease·S P PereiraR Williams
Jul 1, 1995·Liver Transplantation and Surgery : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·M DaasJ L Steers
Feb 7, 2001·Critical Care Medicine·T S WalshA Lee
May 4, 2000·The New England Journal of Medicine·UNKNOWN Acute Respiratory Distress Syndrome NetworkArthur Wheeler
Jun 10, 2000·Journal of Gastroenterology and Hepatology·S K AcharyaS D Gupta
Aug 29, 2000·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·A J EllisR Williams
Sep 26, 2000·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·N RolandoR Williams
Apr 17, 2001·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·G I StraussF S Larsen
Feb 6, 2002·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·UNKNOWN American College of Critical Care Medicine of the Society of Critical Care Medicine, American Society of Health-System Pharm
Mar 21, 2002·Critical Care Medicine·Judith JacobiUNKNOWN Task Force of the American College of Critical Care Medicine (ACCM) of the Society of Critical Care Medicine (SCCM), America
Jun 20, 2002·Transplantation Proceedings·E F M Wijdicks, S L Nyberg
Aug 7, 2002·Journal of the American Academy of Child and Adolescent Psychiatry·Marcia J SlatteryRachel G Klein
Dec 18, 2002·Annals of Internal Medicine·George OstapowiczUNKNOWN U.S. Acute Liver Failure Study Group

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Citations

Apr 18, 2015·Journal of Veterinary Emergency and Critical Care·Molly A Weingarten, Allison A Sande
Aug 3, 2012·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Rita R Shane
May 3, 2019·Optometry and Vision Science : Official Publication of the American Academy of Optometry·John E McDonald, Jane K Dickinson
Mar 30, 2017·Journal of Family Medicine and Primary Care·K RajarajanSitanshu Sekhar Kar
Sep 12, 2018·The Western Journal of Emergency Medicine·Michael F Harrison
Mar 9, 2021·Surgery·Giolana NunesFlavio Henrique Ferreira Galvão
Jun 25, 2021·World Journal of Transplantation·Ramesh KumarRajeev Nayan Priyadarshi

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Methods Mentioned

BETA
pregnancy test
sedation

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