Multiprofessional Critical Care Review: Adult 2024 (MCCRCA24ON)-13

13_Hepatic Failure

Pdf Summary

The document discusses a case presentation on hepatic failure at the 2024 Society of Critical Care Medicine. The case involves a 36-year-old male with acute Hepatitis A leading to liver failure. The patient presents with hypotension, tachycardia, jaundice, and altered mental status. Treatment includes intubation, fluid resuscitation, and vasopressor support. The audience is asked to consider the diagnosis and treatment approach which includes N Acetyl Cysteine and conservative therapy for Acute Fulminant Viral Hepatitis. The discussion emphasizes the importance of hepatic encephalopathy in liver failure and the benefits of N-AC in improving survival and transplant-free outcomes. Additionally, the document covers complications of acute liver failure, such as organ dysfunction, and the importance of renal replacement therapy in managing complications like hyperammonemia.<br /><br />A second case of a 60-year-old with non-alcohol associated liver disease is presented, highlighting the management of hepatorenal syndrome with vasoconstrictors, albumin, and renal replacement therapy. The document also addresses complications like hepatopulmonary syndrome and portopulmonary hypertension, detailing diagnosis and treatment approaches.<br /><br />The audience is presented with questions about treatment choices for liver disease complications and the prognosis following liver transplantation. The document concludes with discussions on acute kidney injury, the need for liver transplant referral in specific criteria, and addressing patient queries about post-transplant symptoms and treatment continuation. Overall, the text touches on various aspects of liver failure management, including complications, treatment options, and transplant considerations.

Keywords

hepatic failure

acute Hepatitis A

liver failure

hepatic encephalopathy

N Acetyl Cysteine

renal replacement therapy

hepatorenal syndrome

liver transplantation

acute kidney injury

portopulmonary hypertension

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