title: [Treatment of paracetamol poisoning. An indication for liver transplantation?].
abstract: Development of metabolic acidosis (pH < 7.30) or the combination of encephalopathy grade III-IV, coagulopathy (PT > 100s) and oliguric renal failure are associated with a poor prognosis in paracetamol-induced fulminant liver failure. It is important to administer N-acetylcysteine as soon as possible after the overdose, but N-acetyl-cysteine also seems to improve survival when given 36-80h following ingestion. Liver transplantation has been performed in some patients with paracetamol-induced fulminant liver failure, but convincing evidence that transplantation improves survival in this group of patients is still lacking. We discuss the difficulties met in deciding if and when to perform liver transplantation. Renal failure may develop some days after paracetamol poisoning, even in the absence of severe liver damage, and haemofiltration and haemodialysis may be necessary.
authors.affiliation: Medisinsk avdeling A, Rikshospitalet, Oslo.
authors.forename: K M
authors.initials: KM
authors.lastname: Boberg
authors.forename: E
authors.initials: E
authors.lastname: Schrumpf
authors.forename: B
authors.initials: B
authors.lastname: Rogstad
authors.forename: K J
authors.initials: KJ
authors.lastname: Berg
authors.forename: T
authors.initials: T
authors.lastname: Ganes
authors.forename: A
authors.initials: A
authors.lastname: Bergan
mesh_terms: D000082:Acetaminophen / Q000506:poisoning*; D000293:Adolescent; D000328:Adult; D005260:Female; D006501:Hepatic Encephalopathy / Q000139:chemically induced / Q000401:mortality / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation; D011379:Prognosis; D013405:Suicide; D013406:Suicide, Attempted
chemical_list: D000082:Acetaminophen
vernacular_title: Behandling av paracetamolforgiftning. Indikasjon for levertransplantasjon?