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Clinical management of acute hepatic failure

Rahman, T; Hodgson, H; (2001) Clinical management of acute hepatic failure. Intensive Care Medicine , 27 (3) pp. 467-476.

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Acute hepatic failure is a rare clinical syndrome associated with high mortality. Hepatic failure leads to a well-recognised pattern of clinical signs and symptoms, sometimes with rapid deterioration and progression to multi-organ failure. Early recognition of this syndrome is essential for appropriate treatment; once identified, patients benefit from early interventional support and treatment in the intensive care unit. Aggressive management may allow stabilisation of patients before their transfer to specialist liver units. At present, orthotopic liver transplantation is the only treatment modality that provides significant improvement in outcome. This review examines the aetiology and clinical presentation of acute hepatic failure, providing guidelines regarding patient management. We present a critical appraisal of specific clinical areas, including the management of cardiovascular, cerebral, renal, coagulopathic and infective complications. Liver transplantation is discussed as well as emerging therapies including non-biological and hybrid liver support systems that may provide a "bridge to transplantation"

Type: Article
Title: Clinical management of acute hepatic failure
Additional information: UI - 21254542 LA - eng PT - Journal Article PT - Review PT - Review, Tutorial DA - 20010517 IS - 0342-4642 SB - IM CY - United States
Keywords: ACUTE LIVER-FAILURE, aetiology, appraisal, As, benefit, bioartificial, bioartificial liver, cardiovascular, Care, Cerebral, CEREBRAL BLOOD-FLOW, clinical, Clinical management, CLINICAL PRESENTATION, COMPLICATION, complications, critical, Critically Ill, EARLY INDICATORS, EMERGING, English, FAILURE, guideline, Guidelines, Hepatic, hepatic failure, HEPATIC-FAILURE, hepatorenal, HEPATORENAL- SYNDROME, hybrid, IMPROVEMENT, INTENSIVE CARE, Intensive Care Unit, INTENSIVE-CARE, interventional, INTRACRANIAL-PRESSURE, liver, Liver Failure, Liver Transplantation, LIVER-TRANSPLANTATION, Management, May, MED, modality, MORTALITY, multiorgan failure, NEW-YORK, orthotopic liver transplantation, outcome, OXYGEN-TRANSPORT, Patient, patients, Pattern, PROGRESSION, PROSPECTIVE CONTROLLED TRIAL, recognition, renal, Review, SEPTIC SHOCK, SIGNS, Specialist, support, SYMPTOM, SYMPTOMS, Syndrome, SYSTEM, SYSTEMS, THERAPIES, therapy, transfer, transplantation, treatment, unit, UNITS, USA, aetiology, Brain Edema, diagnosis, Disease Progression, etiology, IM, Infection, Kidney Failure, LA, Acute, Liver, Artificial, Methods, Monitoring, Physiologic, Multiple Organ Failure, Patient Selection, physiopathology, Practice Guidelines, Severity of Illness Index, STATE, STATES, Time Factors, Treatment Outcome, united, United States, UNITED-STATES
UCL classification: UCL > School of Life and Medical Sciences
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences
URI: http://discovery.ucl.ac.uk/id/eprint/156154
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