Critical Care Scenarios Episode 84: Acute liver failure with Sergio Navarrete
Jan 22, 2025
Join Dr. Sergio Navarrete, an expert in transplant anesthesia, as he navigates the complex world of acute liver failure management. He dives into the critical assessment of liver function, highlighting the balance of supportive care and the importance of hemodynamic optimization. Discover the evolving role of N-acetylcysteine and the challenges of cerebral edema linked to ammonia levels. Dr. Navarrete emphasizes the intricacies of coagulopathy and the vital considerations for timely liver transplantation, showcasing his depth of knowledge in this high-stakes field.
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High Enzymes
- Very high liver enzyme levels (thousands) are concerning for acute liver failure, especially in patients with pre-existing conditions.
- Shock liver or acute liver failure may be indicated, necessitating further investigation.
Managing Acute Liver Injury
- Aggressively pursue reversible causes of liver injury.
- Optimize hemodynamics, focusing on both left and right sides of circulation, possibly with a Vexus score or ultrasound.
Congestion and Liver Failure
- Congestion and congestive hepatopathy can cause severe liver failure.
- Look beyond just swollen legs and consider the potential impact on liver function in acute settings.