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Managing Multiorgan Disease in Acute-On-Chronic Liver Failure: Improving Critical Care Management of the HRS/AKI Patient
Continuing Education

Online accredited continuing education (ACE) release date: May 18, 2022 
SCCM Product Code: SWEB22A
ACE expiration date: May 30, 2023 
Estimated time for activity completion: 1 hour

Learning Objectives
  • Discuss the terms cirrhosis, decompensation, and acute-on-chronic liver failure (ACLF), as well as their clinical significance and risk to patient mortality
  • Review current evidence for the whole-patient management of multiorgan failure arising from ACLF, including risks to renal and respiratory function
  • Apply evidence-based fluid management protocols to revolumize patients with ascites following large-volume paracentesis in AKI patients to establish a diagnosis of HRS/AKI, while mitigating risks from fluid overload
  • Intervene with proactive evidence-based vasoconstrictor therapy for patients who meet diagnostic criteria for HRS/AKI based on American Association for the Study of Liver Diseases (AASLD) and European Association for the Study of the Liver (EASL) algorithms
  • Monitor patients with cirrhosis, ascites, and HRS/AKI for treatment-emergent adverse events that may worsen prognosis
Target Audience
This continuing education activity is intended to meet the needs of all practitioners who care for critically ill patients, including:

  • Advanced practice nurses
  • Anesthesiologists
  • Clinical nurse specialists
  • Clinical pharmacists
  • Critical care educators
  • Emergency department physicians
  • Family practice physicians
  • ICU medical directors
  • ICU nurse managers
  • Internists In-training professionals
  • Neurologists
  • Neurosurgeons
  • Nurses, adult and pediatric
  • Pharmacists
  • Physicians
  • Physician assistants
  • Research scientists
  • Trauma surgeons
  • Other critical care practitioners
Type of Activity

This self-directed activity includes elements that increase knowledge, application and practice for the multiprofessional team members.

This program is supported by an education grant from Mallinckrodt.

Claiming Credit

You can access course materials, and posttests; complete your evaluation and claim your ACE credit by logging in to your MySCCM account with your SCCM Customer ID and password, then clicking on the icon for the course you are enrolled in under the MyLearning tab. If needed, you can click "Forgot my password" to reset your secure password.

Credit Hours

Successful completion of this continuing medical education (CME) activity, which includes participation and a passing score of 70% (three attempts) on the posttest and completion of the overall evaluation, enables the participant to earn up to 1.0 credit hours.

Accreditation Statement: The Society of Critical Care Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement: The Society of Critical Care Medicine designates this enduring educational activity for a maximum of 1.0 AMA PRA Category 1 credit™. Each physician should claim only those hours of credit that they actually spent in the educational activity.

The Pneumonia and Sepsis in Critical Care: Navigating a Complex Patient Diagnostic Workup activity has been approved by the California Board of Registered Nursing, Provider No. 8181, for up to 1.0 contact hours.
ACPE LogoPharmacists:
The Society of Critical Care Medicine is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This enduring educational activity provides up to 1.0 contact hours of continuing education credit.  


SCCM reports to a continuing pharmacy education (CPE) tracking service, CPE Monitor, which will authenticate and store data for completed CPE units received by pharmacists and pharmacy technicians. The tracking system will make CPE data for each participant available to the state boards of pharmacy where the participant is licensed or registered. After CPE units are processed by ACPE and the National Association of Boards of Pharmacy (NABP), pharmacists and pharmacy technicians will be able to log in to a comprehensive electronic profile to access information about their completed CPE. 

Physician Assistants:
AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician Assistants may receive a maximum of 1.0 Category 1 credits for completing this activity.

SCCM Grievance Policy
To provide due process in the evaluation and mediation of grievances concerning ACE activities, this Grievance Procedures Policy was developed. Grievances may concern, but are not limited to, the awarding of credit for individual participation and/or registration fees issues.

  • A written complaint or grievance should be submitted to the Education Department.
  • The Education Department will attempt to resolve the grievance of the complainant.
  • If the initial response is unsatisfactory to the complainant, the matter will be referred to the CEO/EVP for action.
  • If the response from the CEO/EVP is unsatisfactory to the complainant, the matter will be referred to the SCCM EC. The ruling of the EC will be final.
Planner and Faculty Information

The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established conflict-of-interest resolution process and have stated that these reported relationships will not have any impact on their ability to provide unbiased content. 

Jose L. Diaz-Gomez, MD, FASE, FCCM
Chief, Cardiothoracic, MCS, and Transplant Critical Care Section
Baylor Saint Luke’s Medical Center Bellaire, Texas
No relevant financial relationship(s) to disclose

Meghan B. Lane-Fall, MD, MS, FCCM
Associate Professor Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania
No relevant financial relationship(s) to disclose

Heather Meissen, DNP, ACNP, CCRN, FCCM
Emory Healthcare
Fayetteville, Georgia
No relevant financial relationship(s) to disclose

Dawn Herman, BSN, MBA
Associate Director, Accredited Education
Society of Critical Care Medicine
Mount Prospect, Illinois
No relevant financial relationship(s) to disclose

Constantine J. Karvellas MD, MS, FRCPC, FCCM
Professor University of Alberta Edmonton
Alberta, Canada
No relevant financial relationship(s) to disclose

Jody C. Olson MD
University of Kansas Hospital Authority
Shawnee, Kansas
Consultant - Mallinckrodt

Ram Subramanian MBA, MD, FCCM
Professor of Medicine & Surgery Emory University
Atlanta, Georgia
Consultant - Mallinckrodt

Availability: On-Demand
Expires on May 30, 2023
Cost: FREE
Credit Offered:
1 AMA PRA Category 1 Credit Credit
1 ACPE (Pharmacy) – Home Study Credit
1 CABN (Nursing) Credit
1 Certificate of Participation Credit


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