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Management of jaundice in the critically ill 

Management of jaundice in the critically ill
Chapter:
Management of jaundice in the critically ill
Author(s):

Anand D. Padmakumar

and Mark C. Bellamy

DOI:
10.1093/med/9780199600830.003.0193
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date: 26 February 2020

There are many challenges that face intensivists identifying causes of jaundice in intensive care unit (ICU) patients. There is often an inevitable delay in correctly recognizing the aetiology, which can impact on initiating therapy. Despite appropriate institution of therapy in the form of fluids, vasoactive agents, mechanical ventilation, and nutrition, there is a possibility of inadvertently worsening hepatic injury due to various pathophysiological mechanisms discussed previously. This chapter aims to provide principles of management of the acutely-jaundiced ICU patient, focusing upon strategies to prevent hepatic injury, then reviewing therapeutic strategies for the management of liver injury per se. Specific treatment strategies are matched to aetiological categories. Definitive management should not delay initial resuscitation measures that can prevent secondary injury to vital organs. Some novel therapies are also discussed that might play a key role in future patient management.

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