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 Vol. 19 No. 3, March 2008
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AAP Grand Rounds 19:32-33 (2008)
© 2008 American Academy of Pediatrics

CRITICAL CARE

Intensive Care of Patients with Acute Liver Failure

Source: Stravitz RT, Kramer AH, Davern T. et al. Intensive care of patients with acute liver failure: recommendations of the US Acute Liver Failure Study Group. Crit Care Med. 2007;35(11):2498–2505; doi:10.1097/01.CCM.0000287592.94554.5F[Medline]

The first 20% of the full text of this article appears below.

The Adult US Acute Liver Failure (ALF) Study Group was founded in 1997 to define the epidemiology and management of patients with ALF. The group includes individuals from 23 prominent liver transplant centers.

To more uniformly manage patients with ALF at participating centers, the Group convened in 2005 to review the available literature on the management of ALF, to compare the intensive care of patients with intracranial hypertension of various etiologies, and to compare practices within participating centers.

Investigators in specialties outside of hepatology were invited to participate in formulating a standard study-wide management protocol. The present protocol expounds on a previous position paper sanctioned by the American Association for the Study of Liver Disease to offer general guidelines for management of adult patients with ALF.

The Group recommends patients with acute liver injury and hepatocellular insufficiency, defined as an international normalized ratio (INR; the ratio of a patient’s prothrombin time to a normal, control sample) >1.5, be admitted to a hospital. At the onset of encephalopathy, patients should be transferred to . . . [Full Text of this Article]

Christopher Naun, MD, FAAP
Pediatric Critical Care Medicine, University of Utah, Salt Lake City, UT