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Acute-on-chronic liver failure

management and prognosis

Olson, Jody C.

Current Opinion in Critical Care: April 2019 - Volume 25 - Issue 2 - p 165–170
doi: 10.1097/MCC.0000000000000595
GASTROINTESTINAL SYSTEM: Edited by Constantine J. Karvellas

Purpose of review Hospitalizations due to complications of cirrhosis continue to rise. Patients with chronic liver disease who suffer acute decompensation [acute-on-chronic liver failure (ACLF)] often require intensive care support and are at high risk for short-term mortality. Given the high mortality rate associated with this condition is incumbent on intensive care providers who care for this patient population to have a working knowledge of ACLF with its associated complications, management strategies and prognosis.

Recent findings Recognizing ACLF as a distinct clinical entity has gained international attention in recent years though a consensus does not exist. There has been progress on better defining this clinical entity and recent studies have begun to address the critical care needs of these patients. Additional studies are required to define the best care practices for patients with ACLF.

Summary ACLF is a condition occurring in patients with chronic liver disease which is commonly associated with a need for intensive care support and carries a high risk of short-term mortality. Intensive care specialists must be familiar with diagnosis and management of this condition.

Departments of Internal Medicine and Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA

Correspondence to Jody C. Olson, MD, FACP, Associate Professor of Medicine and Surgery, 4000 Cambridge St., MS 1023, Kansas City, Kansas 66160, USA. E-mail:

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