Related Experiment Video
Updated: Aug 14, 2025
12:49
Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
Published on: August 17, 2022
2.5K
Liver intensive care for the general intensivist
A Van Eldere1, T Pirani1,2
1King's College Hospital, London, UK.
Anaesthesia
|January 13, 2023
Summary
Intensive care unit patients with liver injury require prompt diagnosis and management to improve outcomes. This review guides the approach to liver failure, focusing on biochemistry interpretation and extrahepatic manifestations.
Area of Science:
- Critical Care Medicine
- Hepatology
- Internal Medicine
Background:
- Liver injury affects up to 20% of intensive care unit (ICU) patients, correlating with poor prognosis.
- Effective management hinges on timely recognition and appropriate interventions.
- Differentiating primary vs. secondary and acute vs. chronic liver failure is crucial but challenging.
Purpose of the Study:
- To provide a structured approach for managing patients with abnormal liver biochemistry in the ICU.
- To guide the interpretation of liver biochemistry patterns and necessary investigations.
- To outline evidence-based management strategies for liver failure and its systemic effects.
Main Methods:
- Narrative review of literature on liver failure in the ICU setting.
- Focus on interpreting deranged liver biochemistry patterns.
- Discussion of investigations to identify etiologies and management of extrahepatic manifestations.
Main Results:
- Presents a systematic approach to ICU patients with deranged liver biochemistry.
- Highlights the importance of considering liver failure as a multisystem disease.
- Offers guidance on when to seek specialist advice or transfer to a tertiary center.
Conclusions:
- A systematic approach to liver biochemistry interpretation and management is vital for ICU patients.
- Comprehensive care must address multisystem effects of liver failure.
- Clear referral criteria optimize patient outcomes and resource utilization.
Related Concept Videos
01:28Esophageal Varices-II: Clinical Features and Management
116
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
116
01:20Acute Kidney Injury V: Interprofessional Care
40
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
40
01:29Chronic Pancreatitis II: Collaborative Care
122
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
122
01:26Diseases of the Liver and Gallbladder
871
Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
871
01:28Chronic Kidney Disease III: Interprofessional Care
67
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
67
01:22Acute Kidney Injury VI: Nursing Management
45
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
45