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Semin Liver Dis 2023; 43(01): 117-132
DOI: 10.1055/a-2015-1290
Review Article

Cirrhosis Management in the Intensive Care Unit

Thomas N. Smith
1   Department of Internal Medicine, Mayo Clinic Rochester, Rochester, Minnesota
,
Alice Gallo de Moraes
2   Division of Pulmonary and Critical Care Medicine, Mayo Clinic Rochester, Rochester, Minnesota
,
Douglas A. Simonetto
3   Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, Minnesota
› Author Affiliations
Funding None.
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Abstract

Patients with cirrhosis frequently require admission to the intensive care unit as complications arise in the course of their disease. These admissions are associated with high short- and long-term morbidity and mortality. Thus, understanding and characterizing complications and unique needs of patients with cirrhosis and acute-on-chronic liver failure helps providers identify appropriate level of care and evidence-based treatments. While there is no widely accepted critical care admission criteria for patients with cirrhosis, the presence of organ failure and primary or nosocomial infections are associated with particularly high in-hospital mortality. Optimal management of patients with cirrhosis in the critical care setting requires a system-based approach that acknowledges deviations from canonical pathophysiology. In this review, we discuss appropriate considerations and evidence-based practices for the general care of patients with cirrhosis and critical illness.

Keywords

cirrhosis - critical care - acute-on-chronic liver failure - sepsis


Publication History

Accepted Manuscript online:
18 January 2023

Article published online:
13 February 2023

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