Managing Adult Acute and Acute-on-Chronic Liver Failure in the ICU

Acute liver failure (ALF) is defined as the development of severe liver injury with associated hepatic encephalopathy and synthetic dysfunction in a patient without known cirrhosis or other preexisting liver disease. Definitions of acute-on-chronic liver failure (ACLF) vary, but generally describe a...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2021-11, Vol.326 (19), p.1964-1965
Main Authors: Han, Xuan, Davis, Andrew M, Parker, William F
Format: Article
Language:English
Subjects:
Acute Disease
Acute-On-Chronic Liver Failure - drug therapy
Acute-On-Chronic Liver Failure - therapy
Cirrhosis
Critical Illness - therapy
Drug overdose
Failure
Glycemic Control
Hepatic encephalopathy
Humans
Hydroxyethyl Starch Derivatives - therapeutic use
Intensive Care Units
Liver
Liver cirrhosis
Liver failure
Liver Failure, Acute - drug therapy
Liver Failure, Acute - therapy
Norepinephrine - therapeutic use
Practice Guidelines as Topic
Vasoconstrictor Agents - therapeutic use
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Summary:Acute liver failure (ALF) is defined as the development of severe liver injury with associated hepatic encephalopathy and synthetic dysfunction in a patient without known cirrhosis or other preexisting liver disease. Definitions of acute-on-chronic liver failure (ACLF) vary, but generally describe a syndrome marked by acutely decompensated cirrhosis and extrahepatic organ dysfunction. Here, Han et al offer guidelines that seek to address the distinct pathophysiology of ALF and ACLF, focusing on the cardiovascular, endocrine, hematologic, pulmonary, and renal systems.
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.2021.12742