ABSTRACT
Acute liver failure (ALF) constitutes a medical emergency requiring the prompt response
of experienced clinicians. As it is relatively infrequent, and tends to evolve rapidly,
decisions concerning care and prognosis must be made promptly. Determining etiology
is vital since prognosis is largely determined by the cause of the illness, and the
use of antidotes may be lifesaving. Estimating the severity of the liver failure is
also important, because if liver transplantation is necessary, it must be undertaken
quickly. No treatment thus far is better than good general care of the comatose patient,
with attention to the special problems associated with acute liver failure: cerebral
edema, infection, circulatory collapse. A number of issues have been debated recently,
including use of prostaglandins and N-acetylcysteine for treatment of all forms of
acute liver failure, and the use of extracorporeal liver assist machines, however,
the efficacy of non-specific treatments for this complex syndrome has not been proven.
KEY WORDS
N-acetylcysteine - prostaglandins - extracorporeal liver assist devices - cerebral
edema - liver transplantation
