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

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

Alkalosis and acidosis occur in acute liver failure. Identify and treat the underlying cause. Base deficits can be corrected by THAM solution (tromethamine injection), which prevents a rise in carbon dioxide, osmolality, and serum sodium.

Severe hypoglycemia occurs in approximately 40% of patients with fulminant hepatic failure. Although hypoglycemia occurs more frequently in children, blood sugar needs to be monitored in adult patients as well. Blood sugars should be maintained in the range of 60-200 mg/dL, using 10% dextrose solution.

Phosphate, magnesium, and potassium levels tend to be low in acute liver failure. Frequent supplementation is required.

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