PedsCrit
Acute Liver Failure with Dr. Jim Squires & Dr. Maria Pliakas--Part 2
May 27, 2024
Dr. Jim Squires and Dr. Maria Pliakas discuss pediatric acute liver failure, focusing on fluid resuscitation, coagulopathy, and prognostic markers. They explore management strategies, coagulation factor replacements, and fluid/electrolyte complications. The podcast emphasizes the importance of multidisciplinary care and collaboration in successful liver transplantation cases.
30:55
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Quick takeaways
- Correcting INR levels in acute liver failure patients may not always be necessary without active bleeding, highlighting the importance of caution and individualized monitoring.
- Using 25% albumin over 5% for replacement therapy can help minimize fluid volume and avoid unnecessary fluid overload in pediatric patients with acute liver failure.
Deep dives
Acute Liver Failure Can Lead to Cardiovascular Dysfunction and Fluid Refractory Shock
Children with acute liver failure are at risk for cardiovascular dysfunction and fluid refractory shock due to a hyperinflammatory reaction that originates in the liver and spreads throughout the body. Inflammatory mediators can drive a surge in inflammatory signals, affecting multiple organ systems. Assessing markers like INR can be challenging, as correcting coagulopathy may not always be necessary without active bleeding or procedures.
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