Dr. Michael Chew @mchew85
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GrepMed Gastroenterology-Hepatology Editor, Academic Hospitalist UC Davis Medical Center Internal Medicine, Yale Gastroenterology Fellow '22
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Management of critically-ill cirrhotic patients

Open Access Source (Intensive Care Med (2018) 44:1932–1935): https://link.springer.com/epdf/10.1007/s00134-018-5078-z?shared_access_token=rKBIIjC6Htq14G82yghJnfe4RwlQNchNByi7wbcMAY63FIMr4IeFUPHZTUFKckgGIQeEsXu7k1NhPo-T8ItytjuWlMH7y0kI6IydY2i7VzU4Y93MfuEKQruo-qIKnVF91JyuQsQbJNPJv3UJYPzkySdSktYPmFVd6xw1xJDLPqY%3D

#cirrhotic #cirrhosis #Management #CriticalCare
critically-ill cirrhotic ... rKBIIjC6Htq14G82yghJnfe4RwlQNchNByi7wbcMAY63FIMr4IeFUPHZTUFKckgGIQeEsXu7k1NhPo-T8ItytjuWlMH7y0kI6IydY2i7VzU4Y93MfuEKQruo-qIKnVF91JyuQsQbJNPJv3UJYPzkySdSktYPmFVd6xw1xJDLPqY%3D #cirrhotic ... #cirrhosis #Management
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
Etiologies of Cirrhosis ... Primary biliary cirrhosis ... #Diagnosis #Differential ... #Hepatology #Cirrhosis
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
Management of Cirrhosis ... ascites removed • Acute ... Indications #Management #Cirrhosis
Cirrhosis - Pathophysiology
 - Ascites Formation
 - Dilutional Hyponatremia
 - Hepatorenal Syndrome
 - Spontaneous Infections

#Cirrhosis #Pathophysiology
Cirrhosis - Pathophysiology ... Infections #Cirrhosis
Causes of Severe Acute Liver Injury
 - Ichemic hepatitis
 - Acute biliary obstruction
 - Drug-Induced liver
Causes of Severe Acute ... hepatitis - Acute ... LiverInjury #Severe #Acute ... #Causes #Differential
Cirrhosis Timeline and Mortality Rate
Compensated Cirrhosis
Stage 1 - No varices (Annual Mortality Rate 1%)
Stage 2 -
Cirrhosis Timeline ... Rate Compensated Cirrhosis ... Decompensated Cirrhosis ... Rate 57%) #Cirrhosis
Table of Causes of Acute Liver Injury
#Diagnosis #Hepatology #Acute #Liver #Injury #Causes #Differential #Incidence #Table #Failure
Table of Causes of Acute ... Diagnosis #Hepatology #Acute ... Injury #Causes #Differential
FibroScan Scale from F0 to F4

#Diagnosis #Hepatology #Fibroscan #Interpretation #Cirrhosis #Fibrosis
Interpretation #Cirrhosis
CHILD PUGH SCORE

#Diagnosis #Hepatology #Cirrhosis #ChildPugh #Score #Criteria #Class
Diagnosis #Hepatology #Cirrhosis
Hepatitis B - Treatment Indications
Treatment not indicated:
 • Immune tolerant state - HBe-Ag detectable, high HBV
Family history of cirrhosis ... or fibrosis • Cirrhosis ... immunosuppression • Acute ... > 3 mg/dL) or acute