Intensive care management of acute liver failure.
The care of patients with acute liver failure (ALF) presents unique clinical challenges to the practicing physician. It combines the management of rapidly progressive, severe multiple organ failure, unpredictable and often devastating complications, and a need for urgent decision-making in the application of emergency liver transplantation. However, outcomes for patients with this condition have shown progressive improvement over the last four decades. In this article, practical clinical approaches to the care of critically ill patients with ALF are discussed, taking an organ systems-based perspective and discussing the underlying pathophysiological processes and major areas of uncertainty as to what constitutes best practice.
Bernal
William
W
Liver Intensive Therapy Unit, Institute of Liver Studies, King's College Hospital, London, United Kingdom. william.bernal@kcl.ac.uk
Auzinger
Georg
G
Sizer
Elizabeth
E
Wendon
Julia
J
D001927:Brain Diseases / Q000517:prevention & control; D003422:Critical Care / Q000379:methods*; D005334:Fever / Q000517:prevention & control; D005440:Fluid Therapy; D006501:Hepatic Encephalopathy / Q000628:therapy; D006801:Humans; D017053:Infection Control; D017114:Liver Failure, Acute / Q000628:therapy*; D016031:Liver Transplantation; D008991:Monitoring, Physiologic; D018529:Nutritional Support; D011300:Preoperative Care; D017582:Renal Replacement Therapy; D012121:Respiration, Artificial