Acute Liver Failure Flashcards
Define acute liver failure
Failure of liver synthetic and metabolic function in the presence of encephalopathy and the absence of pre-existing liver disease
What are the 3 most common causes of death in ALF
Cerebral oedema
Infection
Multiorgan failure
What is the haemodynamic characteristics of ALF
High cardiac output and low systemic vascular resistance
What is the most common type of infection to develop in ALF
Pulmonary infection
What are the majority of pathogens found
Gram positive - staphylococci
What happens as encephalopathy progresses
There is an increased risk of Intracranial pressure developing
Describe the relationship between encephalopathy and prognosis
As the encephalopathy worsens, the prognosis worsens
What can raised ICP lead to
Brainstem herniation - most common cause of death
Why is prothrombin time measured
The liver has a major role in the production of coagulation factors, inhibitors of coagulation and components of the fibrinolytic system
What are the 2 common causes of renal failure in acute liver failure
Effects of liver cell failure
Acute tubular necrosis
What is the preferred indicator of renal function
Serum creatinine
What are some of the common complications of acute liver failure
Hypokalaemia Hypophosphataemia hypocalcaemia hypomagnesaemia hyponatraemia acidosis
Why does acidosis commonly develop
Inadequate tissue perfusion causing lactic acidosis
Respiratory depression or pulmonary complications causing respiratory acidosis
What is hyperacute hepatic encephalopathy
Within 7 days
What is acute hepatic encephalopathy
between 8 and 28 days
