BCC4: David anderson on Acute Liver Failure

Acuteliver

Failure

David AndersonAdvanced Trainee in Intensive Care MedicineAdvanced Trainee in Palliative Medicine

Case

Jaundice

DefinitionEncephalopat

hy

A short time after the onset of

Coagulopathyhttp://www.capitalpath.com.au/about-us/laboratory-

information.aspx

http://patient.co.uk

Encephalopathy

?Aetiology

http://herron.com.auhttp://giantmicrobes.comhttp://onlinepillspro.comhttp://en.wikipedia.orghttp://indyprops.com

Call for Help

http://8774e4voip.com/blog/polycom-soundpoint-ip-bat-phone/

Full Blood Count

Biochemistry

LFTs

Coags (incl fibrinogen)

Group and Screen

Blood Gas (with Lactate)

Paracetamol Level

Viral Hepatitis Serologybeta HCG*

Ammonia

Autoimmune Screen

HIV

Amylase/Lipase

Send Labs

http://www.npsg.uwaterloo.ca/people/daniel/rendering/

Give NAC

http://nutralife.com

ICU Housekeeping

http://allposters.com.au

http://mooselicker.wordpress.com/2012/09/24/continuations/

Early Vascular Access

http://medgadget.com

Haemodynamics

http://lcars47.comhttp://

transfusion.com.auhttp://hospira.com

http://indiamart.comhttp://healthfirst.com

Encephalopathy

http://www.urmc.rochester.edu/hslt/courses/neuroslides/lab2a/slide063.cfm

Encephalopathy

?http://valleyvet.com

http://nursingcrib.comhttp://hexal-elements.de

Start CRRT Early

http://gambro.com

Ammonia

http://www.luckymojo.com/ammonia.html

Coagulation

http://varnerlab.org

TEG

Patton et al, 2012http://www.aacc.org/publications/cln/2011/April/Pages/PlateletFunction.aspx

Microbiology

http://giantmicrobes.com

Transplant

http://liverfoundation.org.au

Cholongitas et al, 2012

Prognosis

Palliative Care

Extracorporeal Support?

Summary

@expensivecarehttp://expensivecare.com/2013/08/25/alf