Acute Liver Failure

Pharmacy to Dose: The Critical Care Podcast

Acute Liver Failure

Special Guest: Stephanie Bass, PharmD, BCPS, BCCCP

Show Notes: https://pharmacytodose.files.wordpress.com/2020/05/acute-liver-failure-show-notes.pdf

Reference List: https://pharmacytodose.files.wordpress.com/2020/05/acute-liver-failure-references.pdf

03:05 – Stephanie’s interest in the liver; 05:54 – Diagnosing ALF; 07:20 – Does having liver disease increase ALF risk?; 09:00 – Ultimate goal when treating ALF; 10:07 – Patient presentation; 11:58 – Common causes of ALF; 13:30 – ICP and cerebral edema management in ALF; 15:50 – PAD management in ALF; 18:55 – Acute hepatic encephalopathy management; 21:00 – Trending ammonia levels?; 22:25 – NAC for APAP overdose ALF; 27:11 – NAC for non-APAP overdose ALF; 30:23 – Albumin for ALF fluid resuscitation; 34:33 – Vasopressor use; 36:53 – Blood pressure goals; 40:00 – TEG for bleeding risk assessment; 43:45 – Hemostatic agents for coagulopathy; 46:18 – Anticoagulant of choice; 47:59 – Hepatic dose adjustments; 52:12 – Medication dosing with MARS/RRT; 54:00 – Medications to avoid; 56:02 – Transplant considerations; 58:24 – Take-home points

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