Tasty Morsels of Critical Care Tasty Morsels of Critical Care 088 | Acute Liver Failure
Sep 15, 2025
Dive into the critical world of acute liver failure, where understanding the distinction from acute-on-chronic liver failure is crucial for diagnosis and management. Discover the main presentations like coagulopathy and encephalopathy, and explore various causes, including toxins and viral infections. The conversation also navigates through complications, such as intracranial hypertension, and highlights cutting-edge treatments like high-dose CRRT and urgent transplant referrals. It's a whirlwind through life-saving critical care insights!
AI Snips
Chapters
Transcript
Episode notes
Definition And Key Diagnostic Criteria
- Acute liver failure is a massive parenchymal injury causing multi-organ dysfunction with required encephalopathy and coagulopathy.
- This diagnosis assumes a previously normal liver, distinguishing it from acute-on-chronic disease.
Contrast With Acute-On-Chronic Disease
- Acute-on-chronic involves decompensation of pre-existing liver disease and often features portal hypertension.
- Portal hypertension is substantial in acute-on-chronic but typically absent in acute liver failure.
Always Consider Paracetamol First
- Prioritise paracetamol as the most likely cause in Western acute liver failure presentations.
- Consider staggered overdoses and therapeutic misadventures, and check paracetamol exposure early.