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Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... EmoryGastroHep #ACLF #Acute ... Failure #Cirrhosis #Hepatology ... #gastroenterology ... #management #diagnosis
Commonly Observed Laboratory Findings in Hepatic / Liver Failure
 - Elevated conjugated and unconjugated bilirubin -
—100-fold with acute ... liver failure; ... chronic anemia; blood ... indicate a GI bleed ... LiverFailure #Hepatic #Hepatology
GI Bleed - Rapid Response Management

1) Ask for en route: Vitals, categorization, volume of blood loss,
Response Management ... categorization, volume of blood ... Categorize and Stabilize ... Gastrointestinal #gastroenterology ... #Management #criticalcare
Blood Transfusion Reactions

Immune Mediated:
 • Febrile Non-Hemolytic Transfusion Reaction (FNHTR): Most common immune reaction to transfusion.
Acute Hemolytic ... Transfusion Related Acute ... eruptions, diarrhea, liver ... Transfusion #diagnosis #management ... #hematology #reactions
Blood Product Transfusions One Pager Summary
Type and screen - determines blood type and detects in recipient
- Acute Hemolytic ... Transfusion Related Acute ... eruptions, diarrhea, liver ... Transfusions #diagnosis #management ... #hematology #reactions
Disseminated Intravascular Coagulation (DIC) Overview

Increased Clotting and Consumption of Clotting Factors

Findings:
 • Bleeding
 • Recent history
malignancy (Especially acute ... ABO incompatible blood ... DIC • Severe Liver ... causes #treatment #management ... #hematology
Algorithm for the management of patients presenting with acute Lower GI Bleed
High-risk patients
Multiple high-risk clinical features.a
presenting with acute ... Lower GI Bleed ... features.a hemodynamic instability ... if indicated, blood ... IV fluids and blood
Acute Non-Variceal Upper GI Bleeding
Pre-Endoscopy Management:
 • Hemodynamic resuscitation
 • No routine NG tube
 • Risk
Acute Non-Variceal ... Pre-Endoscopy Management ... • Restrictive blood ... • Rescope if bleed ... #gastroenterology
Artificial Liver Support Systems
Bridge between transplantation to allow a patient's liver to recover
When used: Acute liver
recover When used: Acute ... Acute-on-chronic ... Dialysis (SPAD) - Blood ... Support #Systems #hepatology ... #management