Journal
CURRENT OPINION IN CRITICAL CARE
Volume 14, Issue 2, Pages 202-207Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MCC.0b013e3282f6a40d
Keywords
acute-on-chronic liver failure; cirrhosis; intensive care; organ dysfunction; outcome
Categories
Ask authors/readers for more resources
Purpose of review The incidence of cirrhosis is increasing exponentially and is associated with significant morbidity and mortality. This cirrhotic population is prone to infection, which is a frequent precipitant for the development of organ dysfunction; a syndrome often referred to as 'acute-on-chronic' liver failure. Historically, the perception of cirrhosis with organ dysfunction as having a poor prognosis has led to invariably iniquitous access to intensive care. Data to support this view, however, are lacking. Recent findings Acute variceal bleeding is associated with markedly improved survival and warrants organ support in intensive care. Survival correlates directly with the number of organs failing, with sepsis and multiorgan failure resulting in over 90% mortality. The requirement for renal replacement therapy confers a poor prognosis in patients not suitable for liver transplantation. Summary Admission to intensive care for many patients with cirrhosis is not futile, particularly for those with single organ dysfunction and acute variceal bleeding. It can be extremely challenging to manage patients with organ dysfunction and encephalopathy in a ward environment, and these patients frequently require, and indeed benefit from, augmented levels of care in high-dependency and intensive care environments.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available