Current Concepts in Adult Critical Care-Management of Acute and Acute-on-Chronic Liver Failure in the ICU

Management of Acute and Acute-on-Chronic Liver Failure in the ICU

Video Transcription

Video Summary

The speaker discussed updates in the management of acute liver failure and acute on chronic liver failure, focusing on changes in management strategies and recent literature findings. Acute on chronic liver failure typically involves known cirrhosis with additional organ failure, while acute liver failure can be hyperacute or acute, often due to drug-induced liver injury like acetaminophen. Management includes addressing complications like variceal bleeding, hepatic encephalopathy, and spontaneous bacterial peritonitis. For hepatic encephalopathy, lactulose is commonly used, with adjunctive therapies like rifaximin and L-ornithine L-asparaginase showing promise. In acute liver failure, managing hyperammonemia and cerebral edema is critical, with therapeutic plasma exchange showing improved outcomes in severe cases. The challenge lies in availability and resource utilization. Researchers are exploring innovative approaches like integrating pharesis with CVVH as a potential solution.

Keywords

acute liver failure

acute on chronic liver failure

management strategies

organ failure

complications

therapeutic plasma exchange

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