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Acute liver Failure David Anderson Advanced Trainee in Intensive Care Medicine Advanced Trainee in Palliative Medicine

BCC4: David anderson on Acute Liver Failure

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David Anderson gives an entertaining and informative talk about Acute Liver Failure at BCC4. He covers thinking about diagnosis, management and prognosis of acute liver failure. The podcast for this presentation is found at www.intensivecarenetwork.com

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Page 1: BCC4: David anderson on Acute Liver Failure

Acuteliver

Failure

David AndersonAdvanced Trainee in Intensive Care MedicineAdvanced Trainee in Palliative Medicine

Page 2: BCC4: David anderson on Acute Liver Failure
Page 5: BCC4: David anderson on Acute Liver Failure
Page 7: BCC4: David anderson on Acute Liver Failure

Case

Page 8: BCC4: David anderson on Acute Liver Failure
Page 9: BCC4: David anderson on Acute Liver Failure

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

Page 10: BCC4: David anderson on Acute Liver Failure

?Aetiology

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

Page 11: BCC4: David anderson on Acute Liver Failure

Call for Help

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

Page 12: BCC4: David anderson on Acute Liver Failure

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/

Page 13: BCC4: David anderson on Acute Liver Failure

Give NAC

http://nutralife.com

Page 14: BCC4: David anderson on Acute Liver Failure

ICU Housekeeping

http://allposters.com.au

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

Page 15: BCC4: David anderson on Acute Liver Failure

Early Vascular Access

http://medgadget.com

Page 16: BCC4: David anderson on Acute Liver Failure

Haemodynamics

http://lcars47.comhttp://

transfusion.com.auhttp://hospira.com

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

Page 17: BCC4: David anderson on Acute Liver Failure

Encephalopathy

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

Page 18: BCC4: David anderson on Acute Liver Failure

Encephalopathy

?http://valleyvet.com

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

Page 19: BCC4: David anderson on Acute Liver Failure

Start CRRT Early

http://gambro.com

Page 20: BCC4: David anderson on Acute Liver Failure

Ammonia

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

Page 21: BCC4: David anderson on Acute Liver Failure

Coagulation

http://varnerlab.org

Page 22: BCC4: David anderson on Acute Liver Failure

TEG

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

Page 23: BCC4: David anderson on Acute Liver Failure

Microbiology

http://giantmicrobes.com

Page 24: BCC4: David anderson on Acute Liver Failure

Transplant

http://liverfoundation.org.au

Page 25: BCC4: David anderson on Acute Liver Failure

Cholongitas et al, 2012

Prognosis

Page 26: BCC4: David anderson on Acute Liver Failure

Palliative Care

Page 27: BCC4: David anderson on Acute Liver Failure

Extracorporeal Support?

Page 28: BCC4: David anderson on Acute Liver Failure

Summary

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