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Intensive Care for Emergency SurgeonsAcute Hepatic Failure in the ACS Patient: Nuts and Bolts of Pathophysiology and Therapy

Intensive Care for Emergency Surgeons: Acute Hepatic Failure in the ACS Patient: Nuts and Bolts... [Acute liver failure (ALF) is a poor prognosis state defined as an acute and severe hepatic lesion with encephalopathy, in patients without previous liver disease. The etiology, much more than the time of disease, will define its prognosis. There are numerous causes of AHF, such as viral hepatitis, the use of drugs, metabolic diseases, toxic exposure and sepsis, and ischemia that are common to be observed on the acute care surgery patient; however, discovery of possible etiologic agents is not always successful, and about 40–50% of the cases are without determined cause. Synthetic dysfunction may complicate liver injury and lead to systemic complications and occasionally to acute liver failure. Despite poor specificity, routine laboratory biochemistry, such as aminotransferases, bilirubin, INR, and factor V, may help to detect liver injury but remains of limited value in evaluating hepatic function. To identify liver injury or dysfunction in critically ill patients remains a significant challenge. The development of novel techniques to assess hepatic function at the bedside potentially may help to standardize the definition of acute liver injury or dysfunction. Currently, supportive therapy for most patients remains the mainstay of therapy. In this chapter, we seek to review the most important aspects of the pathophysiology and therapy of acute surgical patients admitted in the ICU.] http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png

Intensive Care for Emergency SurgeonsAcute Hepatic Failure in the ACS Patient: Nuts and Bolts of Pathophysiology and Therapy

Part of the Hot Topics in Acute Care Surgery and Trauma Book Series
Editors: Picetti, Edoardo; Pereira, Bruno M.; Razek, Tarek; Narayan, Mayur; Kashuk, Jeffry L.
Pereira, Bruno M.
Intensive Care for Emergency Surgeons — May 30, 2019
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Publisher
Springer International Publishing
Copyright
© Springer Nature Switzerland AG 2019
ISBN
978-3-030-11829-7
Pages
133 –144
DOI
10.1007/978-3-030-11830-3_8
Publisher site
See Chapter on Publisher Site

Abstract

[Acute liver failure (ALF) is a poor prognosis state defined as an acute and severe hepatic lesion with encephalopathy, in patients without previous liver disease. The etiology, much more than the time of disease, will define its prognosis. There are numerous causes of AHF, such as viral hepatitis, the use of drugs, metabolic diseases, toxic exposure and sepsis, and ischemia that are common to be observed on the acute care surgery patient; however, discovery of possible etiologic agents is not always successful, and about 40–50% of the cases are without determined cause. Synthetic dysfunction may complicate liver injury and lead to systemic complications and occasionally to acute liver failure. Despite poor specificity, routine laboratory biochemistry, such as aminotransferases, bilirubin, INR, and factor V, may help to detect liver injury but remains of limited value in evaluating hepatic function. To identify liver injury or dysfunction in critically ill patients remains a significant challenge. The development of novel techniques to assess hepatic function at the bedside potentially may help to standardize the definition of acute liver injury or dysfunction. Currently, supportive therapy for most patients remains the mainstay of therapy. In this chapter, we seek to review the most important aspects of the pathophysiology and therapy of acute surgical patients admitted in the ICU.]

Published: May 30, 2019

Keywords: Acute hepatic failure; Fulminant hepatic failure; Acute care surgery; Acute care

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