ABSTRACT
A substantial number of patients with liver failure are admitted to the intensive
care unit; thus a thorough understanding of the prevention and treatment of complications
in such patients is imperative. The management of liver failure is demanding and often
involves the combined efforts of many specialists. Critically ill patients with hepatic
failure encompass a broad spectrum of disease, ranging from acute liver failure in
a patient with no prior history of liver disease, to acute on chronic liver failure.
The initial assessment and management of acute liver failure are reviewed with an
emphasis on the prevention and treatment of brain edema in the pretransplant setting.
The current treatment of complications resulting from decompensated chronic liver
disease such as portal hypertensive bleeding; infection, renal failure, and hepatic
encephalopathy are then discussed.
KEYWORDS
Liver failure - cerebral edema - portal hypertension - management
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Arun SanyalM.D.
Division of Gastroenterology, Department of Internal Medicine, Virginia Commonwealth
University
MCV Box 980341, Richmond, VA 23298-0341
eMail: ajsanyal@hsc.vcu.edu
