Multiprofessional Critical Care Review: Pediatric 2024 (MCCRCP24ON)-14

14_Hepatic Failure

Pdf Summary

Dr. Rajit K. Basu's presentation focuses on hepatic failure and organ transplantation, emphasizing key points such as interpreting liver failure pathophysiology, recognizing associated distal organ effects, and managing peri-transplant care. The epidemiology of pediatric acute liver failure (ALF) shows varying incidences and causes by age, with most cases being indeterminate. ALF presentations are complex and may involve encephalopathy, seizures, ascites, and laboratory abnormalities. The management of ALF includes early supportive measures, nutritional interventions, lactulose, hemostasis support, and monitoring for seizures. Additionally, extra-hepatic associations of ALF can impact other organ functions, such as hepatorenal syndrome causing renal vasoconstriction and acute kidney injury. Peri-transplant management is crucial, with considerations for surgical factors like arterial thrombus and post-transplant immunosuppression. Special focus is required on monitoring metabolic parameters, managing hepatic encephalopathy, and supporting associated organ dysfunction. Overall, a high suspicion for hepatic failure is advised, with tailored management strategies for liver metabolism, neurological impairments, and overall patient care.

Keywords

hepatic failure

organ transplantation

liver pathophysiology

pediatric acute liver failure

encephalopathy

peri-transplant care

hepatorenal syndrome

nutritional interventions

post-transplant immunosuppression

seizure management

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