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[When should a liver disease patient be admitted to the intensive care unit?]

Authors :
Kaya E
Nekarda P
Traut I
Aurich P
Canbay A
Katsounas A
Source :
Medizinische Klinik, Intensivmedizin und Notfallmedizin [Med Klin Intensivmed Notfmed] 2024 Sep; Vol. 119 (6), pp. 470-477. Date of Electronic Publication: 2024 Jul 17.
Publication Year :
2024

Abstract

Liver diseases are a significant global cause of morbidity and mortality. Liver cirrhosis can result in severe complications such as bleeding, hepatic encephalopathy (HE), and infections. Implementing a clear strategy for intensive care unit (ICU) admission management improves patient outcomes. Hemodynamically significant esophageal/gastric variceal bleeding (E/GVB) and grade 4 HE, when accompanied by the need for renal replacement therapy (RRT), are definitive indications for ICU admission. E/GVB, spontaneous bacterial peritonitis (SBP), and infections with multidrug-resistant organisms (MDRO) require close and stringent critical assessment. Patients with severe hepatorenal syndrome (HRS) or respiratory failure have increased baseline mortality and most likely benefit from early ICU treatment. Rapid identification of sepsis in patients with liver cirrhosis is a crucial criterion for ICU admission. Prioritizing cases based on mortality risk and clinical urgency enables efficient resource utilization and optimizes patient management. In addition, "Liver Units" provide an intermediate care (IMC) level for patients with liver diseases who require close monitoring but do not need immediate intensive care.<br /> (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Details

Language :
German
ISSN :
2193-6226
Volume :
119
Issue :
6
Database :
MEDLINE
Journal :
Medizinische Klinik, Intensivmedizin und Notfallmedizin
Publication Type :
Academic Journal
Accession number :
39017943
Full Text :
https://doi.org/10.1007/s00063-024-01160-w