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Management of acute or chronic hepatic failure in the critically ill 

Management of acute or chronic hepatic failure in the critically ill
Chapter:
Management of acute or chronic hepatic failure in the critically ill
Author(s):

Alastair O’Brien

DOI:
10.1093/med/9780199600830.003.0200
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date: 25 February 2020

Acute on chronic liver failure is characterized by an acute deterioration of liver function in a patient with previously compensated cirrhosis secondary to a precipitating event. It is most commonly associated with a very poor prognosis and early identification of the precipitating cause is essential to successfully attempt to reverse decompensation. The most common precipitant is infection and a high index of suspicion is required. Other management is largely supportive with close attention to renal dysfunction being particularly important. All patients admitted to the intensive care unit with complications of cirrhosis warrant consultation with a transplant centre to determine whether they fulfil the criteria for transplantation and for expert advice.

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