scholarly journals Predicting prognosis in acute liver failure: Ammonia and the risk of cerebral edema

Hepatology ◽  
2007 ◽  
Vol 46 (6) ◽  
pp. 1679-1681 ◽  
Author(s):  
Timothy J. Davern
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Cerebral Edema

Acute Hepatic Failure

2019 ◽  
Author(s):  
Derek J Erstad ◽  
Motaz Qadan
Keyword(s):  
Intensive Care ◽  
Respiratory Distress Syndrome ◽  
Liver Failure ◽  
Respiratory Distress ◽  
Acute Liver Failure ◽  
Fulminant Hepatic Failure ◽  
Cerebral Edema ◽  
Hepatic Failure ◽  
Distress Syndrome ◽  
Diagnosis And Management

Acute liver failure (ALF) is a rare but highly morbid condition that is optimally managed by a multidisciplinary team of surgeons, hepatologists, and intensivists at a tertiary care center that specializes in liver disorders. ALF is caused by four primary mechanisms, including viral infections (most commonly Hepatitis A and B); toxicity from acetaminophen overdose or other substances; postoperative hepatic failure ; and miscellaneous causes such as autoimmune hepatitis, genetic disorders, or idiopathic etiologies. Unlike chronic liver failure in which the body develops compensatory, protective mechanisms, ALF may be associated with severe multisystem organ involvement, including respiratory distress syndrome, renal failure, and cerebral edema. Fulminant hepatic failure represents a rapidly progressive form of ALF that portends worse prognosis. Prompt diagnosis and management of multisystem organ dysfunction in an intensive care setting is paramount to survival. However, a subset of patients will fail to improve with medical management alone. Early identification of these individuals for emergent transplant listing has been shown to improve outcomes. Multiple predictive models for ALF survival have been developed, which are based on weighted evaluation of clinical and laboratory parameters. These models may be used to facilitate treatment, predict prognosis, and guide transplant listing. In this chapter, we provide an in-depth review these concepts, focusing on the classification, epidemiology, diagnosis, and management of ALF. This review contains 5 tables and 69 references. Key Words: acute liver failure, acute respiratory distress syndrome, coagulopathy, cerebral edema, fulminant hepatic failure, hepatic necrosis, liver transplantation, metabolic disarray, multidisciplinary intensive care, prognostication

Acetaminophen induced acute liver failure with improving liver biochemistry but worsening cerebral edema: when the king’s college criteria do not help you

2017 ◽  
Vol 2 ◽  
pp. 73-73
Author(s):  
Ahmed Kayal ◽  
Vladimir Marquez-Azalgara ◽  
Siegfried R. Erb ◽  
Charles H. Scudamore ◽  
Eric M. Yoshida
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Cerebral Edema ◽  
King's College ◽  
King’S College Criteria

The brain in acute liver failure. A tortuous path from hyperammonemia to cerebral edema

2008 ◽  
Vol 24 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Peter Nissen Bjerring ◽  
Martin Eefsen ◽  
Bent Adel Hansen ◽  
Fin Stolze Larsen
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Cerebral Edema ◽  
The Brain

scholarly journals Management of Cerebral Edema in Acute Liver Failure

2017 ◽  
Vol 38 (06) ◽  
pp. 821-829 ◽  
Author(s):  
Beverley Kok ◽  
Constantine Karvellas
Keyword(s):  
Intracranial Pressure ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Cerebral Edema ◽  
Treatment Modalities ◽  
Brain Herniation ◽  
Pressure Monitoring ◽  
General Management ◽  
Novel Treatment ◽  
Pressure Lowering

AbstractAdvances in medical care of the acute liver failure patient have led to a significant reduction in mortality related to the condition. Nevertheless, cerebral edema and ensuing brain herniation remains one of the top causes of demise in acute liver failure. Controversy remains regarding the utility of invasive intracranial pressure monitoring as well as usage of novel treatment modalities including therapeutic hypothermia. This review provides a brief summary into the pathophysiology and risk factors for developing cerebral edema in the context of acute liver failure; this review particularly provides a practical focus on general management of the patient with established cerebral edema as well as specific intracranial pressure-lowering strategies.

Restricted protein intake in acute liver failure neither reduces ammonia nor improves cerebral edema but may increase risk of infection

2020 ◽  
Vol 73 ◽  
pp. S27
Author(s):  
Harshita Tripathi ◽  
Jaya Benjamin ◽  
Puja Bhatia Kapoor ◽  
Rakhi Maiwall ◽  
Vandana Saluja ◽  
...  
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Cerebral Edema ◽  
Protein Intake ◽  
Risk Of Infection ◽  
Increase Risk
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