Acute Liver Failure Questions & Answers

Updated: Jun 13, 2017
  • Author: Gagan K Sood, MD; Chief Editor: BS Anand, MD  more...
  • Print
Questions & Answers

Overview

What is acute liver failure?

What are the signs and symptoms of acute liver failure?

Why is identifying the cause critical in the assessment of acute liver failure (ALF)?

Which lab tests may be performed in the diagnosis of acute liver failure (ALF)?

Which procedures are used in the diagnosis of acute liver failure (ALF)?

Which imaging studies are used in the diagnosis of acute liver failure (ALF)?

How is acute liver failure (ALF) treated?

What are the drug treatment options for treatment of acute liver failure (ALF)?

When is surgical intervention indicated for the treatment of acute liver failure (ALF)?

What is acute liver failure (ALF)?

How is acute liver failure (ALF) characterized?

What is the difference in presentation of fulminant hepatic failure (FHF) between children and adults?

How is fulminant hepatic failure (FHF) differentiated from liver failure?

What is intensive care support for acute liver failure (ALF)?

What is the basis for selection of medications for the treatment of acute liver failure?

What is the role of liver support systems in the treatment of acute liver failure?

What is the prognosis of acute liver failure?

What causes morbidity and mortality from acute liver failure?

What is the role of cytotoxic edema in the pathogenesis of acute liver failure (ALF)?

What vasogenic factors are involved in the pathogenesis of acute liver failure?

What is the role of multisystem organ failure in the pathogenesis of acute liver failure (ALF)?

What is the role of acetaminophen toxicity in the pathogenesis of acute liver failure (ALF)?

What are the common causes of acute liver failure (ALF)?

What are the causes of acute liver failure (ALF) during pregnancy?

What is the role of drugs in the etiology of fulminant hepatic failure (FHF)?

What increases the risk of acetaminophen-caused acute liver failure (ALF)?

What are the risk factors for moxifloxacin-caused acute liver failure?

Which medications may cause idiosyncratic hypersensitivity reactions and acute liver failure (ALF)?

Which illicit drugs may cause idiosyncratic hypersensitivity reactions and acute liver failure (ALF)?

Which herbal or alternative medicines may cause idiosyncratic hypersensitivity reactions and acute liver failure (ALF)?

What are the prognostic models used to predict the risk of acute liver failure (ALF)?

Which toxins may cause acute liver failure (ALF)?

What are vascular causes of acute liver failure (ALF)?

Which metabolic diseases cause acute liver failure (ALF)?

Which malignancies can cause acute liver failure (ALF)?

What are miscellaneous causes of acute liver failure (ALF)?

What is the incidence of fulminant hepatic failure (FHF) in the US?

What is the global incidence of acute liver failure?

How does the incidence of acute liver failure vary by race?

How does the incidence of acute liver failure (ALF) vary between men and women?

How does age affect risk for acute liver failure (ALF)?

What are the mortality rate for acute liver failure (ALF)?

What is the prognosis of fulminant hepatic failure (FHF) due to hepatitis A?

What is the prognosis of fulminant hepatic failure (FHF) due to acetaminophen toxicity?

What is the prognosis of non-acetaminophen-induced fulminant hepatic failure (FHF)?

What is the prognosis of Wilson disease that presents as fulminant hepatic failure (FHF)?

What does the onset of encephalopathy in acute liver failure (ALF) indicate?

Presentation

What is the focus of history in the evaluation of acute liver failure?

What should be included in the physical exam of acute liver failure (ALF)?

What do findings of cerebral edema, ascites, hematemesis, or melena indicate in the evaluation of acute liver failure (ALF)?

What causes hypotension or tachycardic in acute liver failure (ALF)?

What are the signs of encephalopathy in patients with acute liver failure (ALF)?

DDX

Which conditions should be included in the differential diagnoses of acute liver failure (ALF)?

What are the differential diagnoses for Acute Liver Failure?

Workup

What should be included in the evaluation of acute liver failure (ALF)?

What are the ACG guidelines for the diagnosis and management of drug-induced liver injury?

What is the role of prothrombin time (PT) in the evaluation of acute liver failure?

What is the role of hepatic enzymes measurement in the evaluation of acute liver failure (ALF)?

What is the role of serum bilirubin measurement in the evaluation of acute liver failure (ALF)?

What is the role of serum ammonia levels in the evaluation of acute liver failure?

What is the role of serum glucose measurement in the evaluation of acute liver failure?

What is the role of serum lactate measurement in the evaluation of acute liver failure (ALF)?

What is the role of arterial blood gases in the evaluation of acute liver failure?

What is the role of serum creatinine measurement in the evaluation of acute liver failure?

What is the role of serum free copper measurement in the evaluation of acute liver failure?

What is the role of serum phosphate measurement in the evaluation of acute liver failure (ALF)?

What is the role of autoimmune markers in the evaluation of acute liver failure (ALF)?

What is the role of acetaminophen studies in the evaluation of acute liver failure (ALF)?

When is a drug screen indicated in the evaluation of acute liver failure (ALF)?

What is the role of blood cultures in the evaluation of acute liver failure (ALF)?

Which viral serologies are performed in the evaluation of acute liver failure (ALF)?

What is the role of ultrasonography in the evaluation of acute liver failure (ALF)?

What is the role of CT scanning in the evaluation of acute liver failure (ALF)?

What is the role of liver biopsy in the evaluation of acute liver failure (ALF)?

When is intracranial pressure monitoring indicated for evaluation of acute liver failure (ALF)?

Treatment

What is the initial management of acute liver failure (ALF)?

When are consultations indicated for the treatment of acute liver failure (ALF)?

When is intubation indicated during the treatment of fulminant hepatic failure (FHF)?

How is encephalopathy managed in patients with acute liver failure (ALF)?

What are the treatment options for cerebral edema in patients with acute liver failure (ALF)?

How are the advanced stages of encephalopathy treated in patients with acute liver failure (ALF)?

How is intracranial pressure monitored in patients with encephalopathy and acute liver failure (ALF)?

How is intracranial hypertension treated in patients with acute liver failure?

What is the role of barbiturates in the treatment of acute liver failure (ALF)?

What is the role of moderate hypothermia in the treatment of acute liver failure (ALF)?

How are hemodynamic derangements treated in patients with acute liver failure (ALF)?

How is coagulopathy treated in patients with acute liver failure?

What is the role of platelet transfusion in the treatment of acute liver failure (ALF)?

How is acetaminophen toxicity treated in patients with acute liver failure (ALF)?

When should N-acetylcysteine (NAC) be administered for treatment of acetaminophen toxicity?

How is mushroom poisoning treated in patients with acute liver failure (ALF)?

When is liver transplantation indicated for treatment of acute liver failure (ALF)?

When is a bioartificial liver indicated in the treatment of acute liver failure (ALF)?

What is the difference between biologic (bioartificial) and nonbiologic liver support systems for management of acute liver failure (ALF)?

What is the role of the molecular adsorbent recirculating system (MARS) in the treatment of acute liver failure (ALF)?

What is the efficacy of liver support systems in the treatment of acute liver failure (ALF)?

How do patients with acute liver failure (ALF) receive nutrients?

What are the potential complications of acute liver failure?

How are acute liver failure (ALF)–induced seizures treated?

How are acute liver failure (ALF)–induced hemorrhages treated?

How do infections complicate acute liver failure (ALF)?

How is renal failure treated in patients with acute liver failure (ALF)?

How are acute liver failure (ALF)-related metabolic imbalances managed?

Medications

Which medications are used for the treatment of acute liver failure (ALF)?

Which medications in the drug class Anesthetic Agents are used in the treatment of Acute Liver Failure?

Which medications in the drug class Benzodiazepine are used in the treatment of Acute Liver Failure?

Which medications in the drug class Barbiturate Agents are used in the treatment of Acute Liver Failure?

Which medications in the drug class Osmotic Diuretic are used in the treatment of Acute Liver Failure?

Which medications in the drug class Antidotes are used in the treatment of Acute Liver Failure?