Acute liver failure resident survival guide: Difference between revisions
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==Management== | ==Management== | ||
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{{familytree | | | | | | | | | | | | | | | A01 | | | | | | |A01=Altered mental status and PT prolongation by 4-6 sec or INR ≥1.5<BR>presenting w/ nonspecific abdominal Sx<BR>w/o preexisting chronic liver disease, cirrhosis and any illness of <26 wks duration}} | {{familytree | | | | | | | | | | | | | | | A01 | | | | | | | | | | | | | | |A01=Altered mental status and PT prolongation by 4-6 sec or INR ≥1.5<BR>presenting w/ nonspecific abdominal Sx<BR>w/o preexisting chronic liver disease, cirrhosis and any illness of <26 wks duration}} | ||
{{familytree | | | | | | | | | | | | | | | |!| | | | | | | |}} | {{familytree | | | | | | | | | | | | | | | |!| | | | | | | |}} | ||
{{familytree | | | | | | | | | | | | | | | B01 | | | | | | |B01=Acute liver failure}} | {{familytree | | | | | | | | | | | | | | | B01 | | | | | | |B01=Acute liver failure}} | ||
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===General Management=== | ===General Management=== | ||
{{familytree/start |summary=PE diagnosis Algorithm.}} | {{familytree/start |summary=PE diagnosis Algorithm.}} | ||
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | A01 | | | | | | |A01=Continuous monitoring under quite environment w/ preventive treatment strategies}} | {{familytree | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | A01 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |A01=Continuous monitoring under quite environment w/ preventive treatment strategies}} | ||
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | | | | |}} | {{familytree | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | | | | |}} | ||
{{familytree | | | | | | | | | | | |,|-|-|-|-|v|-|-|-|-|v|-|-|-|-|v|-|-|-|-|v|-|-|-|-|+|-|-|-|-|v|-|-|-|-|v|-|-|-|-|v|-|-|-|-|v|-|-|-|-|.| |}} | {{familytree | | | | | | | | | | | |,|-|-|-|-|v|-|-|-|-|v|-|-|-|-|v|-|-|-|-|v|-|-|-|-|+|-|-|-|-|v|-|-|-|-|v|-|-|-|-|v|-|-|-|-|v|-|-|-|-|.| |}} | ||
Revision as of 18:38, 6 December 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2]
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
Management
| Altered mental status and PT prolongation by 4-6 sec or INR ≥1.5 presenting w/ nonspecific abdominal Sx w/o preexisting chronic liver disease, cirrhosis and any illness of <26 wks duration | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Acute liver failure | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Mandatory hospital admission | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| w/o altered mental status, significant coagulopathy and abnormal LFT | w/ altered mental status | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| High dependency ward admission | Worsening mental status | ICU admission | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Initial evaluation: Detailed H/o and PE Labs: CBC, PT/INR, serum BCH, ABG, ammonia, acetaminophen and tox screen for other drugs/toxins, viral serology (A-E), autoimmune markers, amylase, lipase, *bilirubin:alkaline phosphatase, blood grouping and typing, HIV status | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| General management | Etiology specific management | Complication specific management | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
General Management
Etiology Specific Management
Complication Specific Management
Do's
Dont's
References
| Continuous monitoring under quite environment w/ preventive treatment strategies | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Cerebral edema and increased ICP | Coagulopathy | Drugs | GI bleeding | Hemodynamic instability | Hepatic encephalopathy | Infections | Metabolic disturbances | NAC | Nutritional deficiency | Renal failure | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||