Advances in critical care hepatology

Area of Science:

• Critical care medicine
• Hepatology
• Internal medicine

Background:

• Complications of liver disease frequently require intensive care unit (ICU) admission.
• Differentiating between acute and chronic liver disease is crucial due to distinct pathophysiological mechanisms.

Purpose of the Study:

• To review the critical care management of acute liver failure and chronic liver disease complications.
• To highlight advances in managing acute liver failure and common chronic liver disease complications.

Main Methods:

• Review of current literature on acute liver failure and chronic liver disease management in the ICU.
• Separate consideration of acute and chronic liver disease based on differing pathophysiologies.

Main Results:

• Acute liver failure management emphasizes intracranial pressure monitoring for Grade III/IV encephalopathy and potential use of moderate hypothermia for refractory intracranial hypertension.
• Chronic liver disease critical care focuses on managing complications like ascites, hepatorenal syndrome, spontaneous bacterial peritonitis, variceal hemorrhage, and hepatic encephalopathy.

Conclusions:

• Effective critical care for liver disease necessitates distinguishing between acute and chronic etiologies.
• Management strategies for acute liver failure and chronic liver disease complications in the ICU are evolving with significant advancements.