Acute liver failure

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18 Citations (Scopus)

Abstract

Acute liver failure is a multiorgan syndrome with dramatic clinical features and, often, a fatal outcome. It is characterized by the onset of coma and coagulopathy within 6 months, and usually in <6 weeks, from onset of illness. Viral hepatitis, drug-related liver injury, and the alcohol-acetaminophen syndrome are the most common etiologies. Altered mental status accompanied by jaundice is a hallmark of acute liver failure. A unique feature is the evolution of increased intracranial pressure due to cerebral edema. The resulting cerebral ischemia and brainstem herniation account for approximately 50% of deaths in patients with acute liver failure. Mannitol therapy may successfully treat most patients with high intracerebral pressure. Most patients demonstrate features of the multiple organ failure syndrome, including a shock-like state, renal failure, and occasionally respiratory distress syndrome. Close monitoring of volume status is necessary, since administration of large quantities of fluid may be required. Infection is also common; most pathogens are gram-positive, and fungal infections are also seen. Because an optimum therapy for acute liver failure does not yet exist, liver transplantation should be considered early, before advanced levels of coma develop. Alternative, experimental treatment modalities include heterotopic liver grafting, administration of hepatocyte growth factor, use of an extracorporeal liver-assist device, and liver cell transplantation, but none of these has attained widespread use.

Original languageEnglish (US)
JournalAmerican Journal of Medicine
Volume96
Issue number1 SUPPL.1
StatePublished - 1994

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Acute Liver Failure
Liver Transplantation
Intracranial Pressure
Coma
Fatal Outcome
Hepatocyte Growth Factor
Multiple Organ Failure
Mycoses
Liver
Cell Transplantation
Brain Edema
Mannitol
Acetaminophen
Jaundice
Brain Ischemia
Hepatitis
Brain Stem
Renal Insufficiency
Shock
Therapeutics

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Acute liver failure. / Lee, William M.

In: American Journal of Medicine, Vol. 96, No. 1 SUPPL.1, 1994.

Research output: Contribution to journalArticle

Lee, WM 1994, 'Acute liver failure', American Journal of Medicine, vol. 96, no. 1 SUPPL.1.
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