- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Section 6 The gastrointestinal system
- Part 6.1 Physiology
- Part 6.2 Gastrointestinal monitoring
- Part 6.3 Gastrointestinal haemorrhage
- Part 6.4 Disordered gastric motility
- Part 6.5 The acute abdomen in the ICU
- Part 6.6 Pancreatitis
- Part 6.7 Jaundice
- Part 6.8 Acute hepatic failure
- Chapter 194 Pathophysiology and causes of acute hepatic failure
- Chapter 195 Diagnosis and assessment of acute hepatic failure in the critically ill
- Chapter 196 Management of acute hepatic failure in the critically ill
- Chapter 197 The effect of acute hepatic failure on drug handling in the critically ill
- Chapter 198 Extracorporeal liver support devices in the ICU
- Part 6.9 Acute on chronic hepatic failure
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care
(p. 920) Diagnosis and assessment of acute hepatic failure in the critically ill
- Chapter:
- (p. 920) Diagnosis and assessment of acute hepatic failure in the critically ill
- Author(s):
Sameer Patel
and Julia Wendon
- DOI:
- 10.1093/med/9780199600830.003.0195
Establishing the aetiology of acute hepatic failure is essential for correct and timely management. An exhaustive history and examination is crucial in targeting investigations and initiating management. Clinical assessment allows risk stratification, identifying those patients who can be managed locally from those best served in a specialist centre with liver transplantation capability. History should focus on the presenting problem, time of onset and speed of deterioration, and establish features consistent with hyperacute, acute or subacute ALF to guide prognostication. Examination should initially focus on rapid assessment and resuscitation before searching for signs leading to more specific differential diagnoses. Investigations should encompass the variety of potential causes, ranging from basic to more specialist studies. Prognostication is critical for stratification of those patients who may benefit from a potentially life-saving transplantation. Several risk stratification and predictive tools exist to differentiate those patients likely to recover, those unlikely to survive despite maximal intervention, and those who would potentially benefit from transplantation.
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- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Section 6 The gastrointestinal system
- Part 6.1 Physiology
- Part 6.2 Gastrointestinal monitoring
- Part 6.3 Gastrointestinal haemorrhage
- Part 6.4 Disordered gastric motility
- Part 6.5 The acute abdomen in the ICU
- Part 6.6 Pancreatitis
- Part 6.7 Jaundice
- Part 6.8 Acute hepatic failure
- Chapter 194 Pathophysiology and causes of acute hepatic failure
- Chapter 195 Diagnosis and assessment of acute hepatic failure in the critically ill
- Chapter 196 Management of acute hepatic failure in the critically ill
- Chapter 197 The effect of acute hepatic failure on drug handling in the critically ill
- Chapter 198 Extracorporeal liver support devices in the ICU
- Part 6.9 Acute on chronic hepatic failure
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care