Sunday, 26 May 2013

Hepatic Failure

It occur due to severe cause of hepatic encephalopathy.
Types of Hepatic Failure:

  1. Fulminant hepatic failure.
  2. Subfulminant hepatic failure.
1. Fulminant hepatic failure:
Defined as severe hepatic failure with development of hepatic encephalopathy within 8 weeks after the onset of acute liver disease.
In the absence of evidence of pre-existing in chronic liver disease that also lead to hepatic encephalopathy.

2. Subfulminant hepatic failure:
It is term used when encephalopathy occur between 8 weeks and 6 months after the onset of acute liver disease and carries an equally poor prognosis.
About 70% cases are caused  by acute viral hepatitis.
50% due to hepatitis B.
Other causes are hepatitis A. E & D.

Clinical Features:
Hepatic encephalopathy.
Small live on examination.

Prothrombin time.
Decreased Coagulation Factors.

* Liver biopsy is contraindicated.


  1. Hepatic Encephalopathy.
  2. Cerebral Edema.
  3. Nutritions.
  4. Cardiovascular functions.
  5. Hemorrhage.
  6. Infections.
  7. Renal failure.
  8. Acetylcysteine.
  9. Liver Transplantaion.
1. Hepatic Encephalopathy:
It occur due to nitrogenous substances e.g. Ammonia it enters in portal circulation that by-pass the liver and lead to cerebral dysfunction.
* Because liver becomes unable to detoxify them.
2. Cerebral Edema:
It is major cause of the death in Hepatic failure.
Its due to signs present of Increased Intracranial Pressure (ICP).
3. Nutitions:
Maintain glucose and other diet balance.
4. Cardiovascular functions:
To maintain the blood pressure, pulse and urine output.
5. Hemorrhage:
Impaired homeostasis due to failure of coagulation factor production can result in bleeding from any site especially from GIT.
* It should need to manage by Different drugs.
6. Infection:
For infection use the broad spectrum drugs.
7. Renal failure:
Perform Dialysis, if there is renal failure.
8. Acetylcysteine:
It is an anidot of Paracetamol (Local Name Pk)
It is helpful for managing Liver / Hepatic failure.
9. Liver Transplantation:
It is perform at the end stage of Hepatic failure.

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