Advanced strategies for intensive care management of acute liver failure.

Fuat H Saner, Dmitri Bezinover, Andrew Gold, Dieter C Broering, Dimitri A Raptis, Ecaterina Scarlatescu, Ehab Abufarhaneh, Saad Ali Alghamdi, Yasser Tolba, Bandar Aljudaibi

Journal: Best practice & research. Clinical gastroenterology 2024;73():101962

PMID: 39709216

Full Text on Elsevier Science View on PubMed

Abstract

Acute liver failure (ALF) is defined as the loss of hepatic function in conjunction with hepatic encephalopathy and coagulopathy. There is histological evidence of profound hepatocyte damage. If it is not aggressively managed, ALF can be fatal within a few days. It is a rare disease, often occurring in patients without prior liver disease. Despite numerous causes, ALF usually presents as acute liver necrosis with a clinical picture that includes cognitive dysfunction, increased aminotransferases, and severe coagulopathy. It is essential to distinguish between ALF and acute-on-chronic liver failure (ACLF). Causes for ALF include paracetamol Acute liver failure (ALF) is characterized by acute liver dysfunction associated with overdose, right heart failure (ischemic liver injury), viral hepatitis (A, B, D and E), autoimmune hepatitis and drug-induced liver injury (including some herbal and nutritional supplements). In developed countries, the prevalence of ALF is 1:1,000,000. Survival rates have increased due to improved ICU management.

Address: Hospital & Research Center, Organ Transplant Center of Excellence, Riyadh, Saudi Arabia. Electronic address: [email protected].; Department of Anesthesia and Intensive Care Medicine III, Fundeni Clinical Institute, Bucharest, Romania; University of Medicine and Pharmacy "Carol Davila", Anesthesia and Intensive Care Department, Bucharest, Romania.; Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA.; Hospital & Research Center, Organ Transplant Center of Excellence, Riyadh, Saudi Arabia.; Hospital & Research Center, Organ Transplant Center of Excellence, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

DOI: 10.1016/j.bpg.2024.101962

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MeSH Terms: Humans, Acetaminophen, Acute-On-Chronic Liver Failure, Chemical and Drug Induced Liver Injury, Critical Care, Diagnosis, Differential, Liver Failure, Acute, Liver Transplantation