Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile.
Unidad de Gastroenterología, Instituto de Medicina, Escuela de Medicina, Universidad Austral de Chile, Chile.
Ann Hepatol. 2019 Jul-Aug;18(4):543-552. doi: 10.1016/j.aohep.2019.04.008. Epub 2019 May 10.
Acute liver failure (ALF) is a severe condition secondary to a myriad of causes associated with poor outcomes. The prompt diagnosis and identification of the aetiology allow the administration of specific treatments plus supportive strategies and to define the overall prognosis, the probability of developing complications and the need for liver transplantation. Pivotal issues are adequate monitoring and the institution of prophylactic strategies to reduce the risk of complications, such as progressive liver failure, cerebral oedema, renal failure, coagulopathies or infections. In this article, we review the main aspects of ALF, including the definition, diagnosis and complications. Also, we describe the standard-of-care strategies and recent advances in the treatment of ALF. Finally, we include our experience of care patients with ALF.
急性肝衰竭(ALF)是一种严重的疾病,继发于多种原因,与不良预后相关。及时诊断和确定病因可以进行特定的治疗以及支持性策略,并确定整体预后、发生并发症的概率以及是否需要肝移植。关键问题是进行充分的监测,并采取预防策略以降低并发症的风险,如进行性肝衰竭、脑水肿、肾衰竭、凝血功能障碍或感染。在本文中,我们将回顾急性肝衰竭的主要方面,包括定义、诊断和并发症。同时,我们还描述了急性肝衰竭的标准治疗策略和最新治疗进展。最后,我们介绍了我们在治疗急性肝衰竭患者方面的经验。