Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU Part 2
Neurology Section
Infectious Diseases Section
Gastroenterology Section
Peri-Transplant Section
Recommendation Grading
Disclaimer
Overview
Title
Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-Transplant Medicine, Infectious Disease, and Gastroenterology Considerations
Authoring Organization
Society of Critical Care Medicine
Publication Month/Year
May 1, 2023
Last Updated Month/Year
April 1, 2024
Document Type
Guideline
Country of Publication
US
Document Objectives
To develop evidence-based recommendations for clinicians caring for adults with acute liver failure (ALF) or acute on chronic liver failure (ACLF) in the ICU. In part 2 of this guideline, the panel was divided into four subgroups: neurology, peri-transplant, infectious diseases, and gastrointestinal groups. We developed and selected Population, Intervention, Comparison, and Outcomes (PICO) questions according to importance to patients and practicing clinicians. For each PICO question, we conducted a systematic review and meta-analysis where applicable. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. We used the evidence to decision framework to facilitate recommendations formulation as strong or conditional. We followed strict criteria to formulate best practice statements.
Inclusion Criteria
Male, Female, Adult, Older adult
Health Care Settings
Emergency care, Hospital, Operating and recovery room
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Diagnosis, Assessment and screening, Treatment, Management
Diseases/Conditions (MeSH)
D017114 - Liver Failure, Acute, D017093 - Liver Failure, D065290 - Acute-On-Chronic Liver Failure
Keywords
acute liver failure, acute on chronic liver failure
Source Citation
Nanchal, Rahul MD, MS, FCCM (Co-Chair)1; Subramanian, Ram MD, FCCM (Co-Chair)2; Alhazzani, Waleed MBBS, MSc, FRCPC (Methods Chair, Vice Co-Chair)3; Dionne, Joanna C. MD, MS, BN3; Peppard, William J. PharmD, BCPS, FCCM4; Singbartl, Kai MD, MPH, EDIC, FCCM5; Truwit, Jonathon MD, MBA6; Al-Khafaji, Ali H. MD, MPH, FCCM7; Killian, Alley J. PharmD, BCPS2; Alquraini, Mustafa MBBS, SBEM, ABEM, MMed8; Alshammari, Khalil MBBS8; Alshamsi, Fayez MBBS8; Belley-Cote, Emilie MD3; Cartin-Ceba, Rodrigo MD, MS9; Hollenberg, Steven M. MD, FACC, FCCM, FAHA10; Galusca, Dragos M. MD, FASA, FCCP11; Huang, David T. MD, MPH, FCCM7; Hyzy, Robert C. MD, MCCM12; Junek, Mats BSc(H), MD3; Kandiah, Prem MD2; Kumar, Gagan MD, MA, MS13; Morgan, Rebecca L. PhD, MPH14; Morris, Peter E. MD15; Olson, Jody C. MD16; Sieracki, Rita MLS6; Steadman, Randolph MD17; Taylor, Beth DCN, RDN-AP, CNSC, FCCM18; Karvellas, Constantine J. MD, MS, FRCPC, FCCM (Vice Co-Chair)19. Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-Transplant Medicine, Infectious Disease, and Gastroenterology Considerations. Critical Care Medicine 51(5):p 657-676, May 2023. | DOI: 10.1097/CCM.0000000000005824