Acute liver failure: A review for emergency physicians.

Area of Science:

• Emergency Medicine
• Hepatology

Background:

• Acute liver failure (ALF) is a rare but critical condition with significant morbidity and mortality.
• Patients often require emergency department (ED) management for life-threatening complications.

Purpose of the Study:

• To provide an evidence-based summary of the emergency medicine evaluation and management of ALF.
• To outline guiding principles for managing ALF-associated complications.

Main Methods:

• This narrative review synthesizes current data on ALF evaluation and management in the ED.
• Focuses on a pathophysiological approach to managing complications.

Main Results:

• ALF incidence is 1-6 cases per million annually, contributing to liver-related deaths and transplants.
• Common complications include encephalopathy, coagulopathy, infections, renal injury, and hemodynamic instability.
• Early consultation with transplant teams improves patient outcomes.

Conclusions:

• Rapid diagnosis and management of ALF and its complications are essential in the ED.
• Identifying the etiology and initiating symptomatic care, alongside early transplant consultation, are imperative.