Improving Survival in Decompensated Cirrhosis
Joint Authors
Patel, Vishal
Jain, Ashokkumar
Mukerji, Amar Nath
Source
International Journal of Hepatology
Issue
Vol. 2012, Issue 2012 (31 Dec. 2012), pp.1-14, 14 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2012-07-02
Country of Publication
Egypt
No. of Pages
14
Main Subjects
Abstract EN
Mortality in cirrhosis is consequent of decompensation, only treatment being timely liver transplantation.
Organ allocation is prioritized for the sickest patients based on Model for End Stage Liver Disease (MELD) score.
In order to improve survival in patients with high MELD score it is imperative to preserve them in suitable condition till transplantation.
Here we examine means to prolong life in high MELD score patients till a suitable liver is available.
We specially emphasize protection of airways by avoidance of sedatives, avoidance of Bilevel Positive Airway Pressure, elective intubation in grade III or higher encephalopathy, maintaining a low threshold for intubation with lesser grades of encephalopathy when undergoing upper endoscopy or colonoscopy as pre transplant evaluation or transferring patient to a transplant center.
Consider post-pyloric tube feeding in encephalopathy to maintain muscle mass and minimize risk of aspiration.
In non intubated and well controlled encephalopathy, frequent physical mobility by active and passive exercises are recommended.
When renal replacement therapy is needed, night-time Continuous Veno-Venous Hemodialysis may be useful in keeping the daytime free for mobility.
Sparing and judicious use of steroids needs to be borne in mind in treatment of ARDS and acute hepatitis from alcohol or autoimmune process.
American Psychological Association (APA)
Mukerji, Amar Nath& Patel, Vishal& Jain, Ashokkumar. 2012. Improving Survival in Decompensated Cirrhosis. International Journal of Hepatology،Vol. 2012, no. 2012, pp.1-14.
https://search.emarefa.net/detail/BIM-463120
Modern Language Association (MLA)
Mukerji, Amar Nath…[et al.]. Improving Survival in Decompensated Cirrhosis. International Journal of Hepatology No. 2012 (2012), pp.1-14.
https://search.emarefa.net/detail/BIM-463120
American Medical Association (AMA)
Mukerji, Amar Nath& Patel, Vishal& Jain, Ashokkumar. Improving Survival in Decompensated Cirrhosis. International Journal of Hepatology. 2012. Vol. 2012, no. 2012, pp.1-14.
https://search.emarefa.net/detail/BIM-463120
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-463120