Initial Management of a Patient Presenting with Liver Failure - Flowchart
Initial Management of a Patient Presenting with Liver Failure - Flowchart Acute Liver Failure Acute Liver Failure
«Flowchart»

Start

Start

Start

Evidence of liver failure?

Evidence of liver failure?

Evidence of liver failure?

Is this decompensated chronic liver disease?

Is this decompensated chronic liver disease?

Is this decompensated chronic liver disease?

Assessment of severity

Assessment of severity

Assessment of severity

Manage according to local protocols

Manage according to local protocols

Manage according to local protocols

End

End

End

Transfer to liver unit

Transfer to liver unit

Transfer to liver unit

Initial resuscitation
NAC

Initial resuscitation
NAC


Initial resuscitation

Organ support

Organ support

Organ support

Appropriate location for management
ICU/HDU

Appropriate location for management
ICU/HDU


Appropriate location for management

Discussion with local liver unit

Discussion with local liver unit

Discussion with local liver unit

Poor prognostic markers?

Poor prognostic markers?

Poor prognostic markers?

Examination

Examination

Examination

Encephalopathy?

Encephalopathy?

Encephalopathy?

Metabolic failure?
Bilirubin, INR

Metabolic failure?
Bilirubin, INR


Metabolic failure?

HDU, high dependency unit; ICU, intensive care unit; INR, international normalized ratio; NAC, N-acetylcysteine.

HDU, high dependency unit; ICU, intensive care unit; INR, international normalized ratio; NAC, N-acetylcysteine.

HDU, high dependency unit; ICU, intensive care unit; INR, international normalized ratio; NAC, N-acetylcysteine.

HDU ICU INR NAC

History

History

History

Evidence of liver failure?

Evidence of liver failure?

Evidence of liver failure?

Initial investigations

Initial investigations

Initial investigations