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Critical Care of the Acute Liver Failure Patient

  • Thomas A. Verbeek
  • Geraldine C. DiazEmail author
  • John F. Renz
Chapter

Abstract

Acute liver failure (ALF) is the abrupt deterioration of hepatic function in an individual with no previous history of liver disease. ALF can be caused by many conditions, and etiology has a significant impact on the anticipated clinical course. Early management focuses on investigating the etiology and assessing the extent of the patient’s hepatic impairment. Multiple prognostic scoring systems exist that predict recovery from ALF. The most common causes of death are sepsis and cerebral herniation. The definitive goals of care are confirming the initial diagnosis, initiating appropriate etiology-directed therapy, monitoring for further hepatic decompensation, supporting homeostasis to facilitate hepatic regeneration, and preventing complications. Most patients recover from ALF, but some require liver transplantation.

Keywords

Acetaminophen Acute liver failure Critical care Hepatic encephalopathy Intracranial pressure Liver transplantation N-acetyl cysteine (NAC) 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Thomas A. Verbeek
    • 1
  • Geraldine C. Diaz
    • 2
    Email author
  • John F. Renz
    • 3
  1. 1.Department of Anesthesiology, Penn State College of MedicineHersheyUSA
  2. 2.Department of Anesthesiology, University of Illinois at ChicagoChicagoUSA
  3. 3.Department of Surgery, University of ChicagoChicagoUSA

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