In this episode of Critical Matters, Dr. Sergio Zanotti interviews Dr. Rahul Nanchal about the management of adult acute and acute-on-chronic liver failure in the ICU, focusing on a guideline Dr. Nanchal co-authored. The discussion covers definitions of different types of liver failure, common problems leading to ICU admissions, and frequent management mistakes. Dr. Nanchal explains the guideline development process, the strength of recommendations (strong vs. conditional), and specific recommendations for cardiovascular and hematologic considerations, including fluid resuscitation, vasopressor use, assessment of bleeding and thrombosis risk, hemoglobin targets, and DVT treatment and prophylaxis. The podcast emphasizes the importance of early recognition, aggressive treatment, and appropriate referral for liver transplant in acute-on-chronic liver failure patients.
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