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

Updated: Jun 13, 2019
  • Author: Gagan K Sood, MD; Chief Editor: BS Anand, MD  more...
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Answer

The most important aspect of treatment in patients with acute liver failure is to provide good intensive care support. [1, 2, 3, 4, 5, 38, 39]  Patients with grade II encephalopathy should be transferred to the intensive care unit (ICU) for monitoring. As encephalopathy progresses, protection of the airway becomes increasingly important.

Most patients with acute liver failure tend to develop some degree of circulatory dysfunction. Careful attention should be paid to fluid management and hemodynamics. [38, 39] Monitoring of metabolic parameters, surveillance for infection, maintenance of nutrition, and prompt recognition of gastrointestinal bleeding are crucial.

Coagulation parameters, complete blood cell count, and metabolic panel should be checked frequently. Serum aminotransferases and bilirubin are generally measured daily to follow the course of the disease.

Bed rest is recommended.


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