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08.08.2023 | Narrative Review

Intensive care management of acute-on-chronic liver failure

verfasst von: Giovanni Perricone, Thierry Artzner, Eleonora De Martin, Rajiv Jalan, Julia Wendon, Marco Carbone

Erschienen in: Intensive Care Medicine | Ausgabe 8/2023

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Abstract

Acute-on-chronic liver failure (ACLF) is a clinical syndrome defined by an acute deterioration of the liver function associated with extrahepatic organ failures requiring intensive care support and associated with a high short-term mortality. ACLF has emerged as a major cause of mortality in patients with cirrhosis and chronic liver disease. ACLF has a unique pathophysiology in which systemic inflammation plays a key role; this provides the basis of novel therapies, several of which are now in clinical trials. Intensive care unit (ICU) therapy parallels that applied in the general ICU population in some organ failures but has peculiar differential characteristics in others. Critical care management strategies and the option of liver transplantation (LT) should be balanced with futility considerations in those with a poor prognosis. Nowadays, LT is the only life-saving treatment that can radically improve the long-term prognosis of patients with ACLF. This narrative review will provide insights on the current understanding of ACLF with emphasis on intensive care management.

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Titel: Intensive care management of acute-on-chronic liver failure
verfasst von: Giovanni Perricone
Thierry Artzner
Eleonora De Martin
Rajiv Jalan
Julia Wendon
Marco Carbone
Publikationsdatum: 08.08.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Intensive Care Medicine / Ausgabe 8/2023
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-023-07149-x

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Intensive care management of acute-on-chronic liver failure

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Springer Medizin

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