Pathogenetic mechanisms of acute hepatic encephalopathy

With the advent of liver transplantation as an accepted therapy for end-stage liver disease, increasing numbers of patients with severe hepatic dysfunction require ICU stabilization and treatment of associated complications. Of these, acute hepatic encephalopathy remains an important cause of morbidity and mortality. We review recent findings concerning interactions between the damaged liver and the brain that may have direct clinical implications in the management of hepatic encephalopathy in the critically ill.