Evaluation and management of emergencies in the patient with cirrhosis

Rev Gastroenterol Mex (Engl Ed). 2022 Apr-Jun;87(2):198-215. doi: 10.1016/j.rgmxen.2022.05.001. Epub 2022 May 13.

Abstract

The approach to and management of critically ill patients is one of the most versatile themes in emergency medicine. Patients with cirrhosis of the liver have characteristics that are inherent to their disease that can condition modification in acute emergency treatment. Pathophysiologic changes that occur in cirrhosis merit the implementation of an analysis as to whether the overall management of a critically ill patient can generally be applied to patients with cirrhosis of the liver or if they should be treated in a special manner. Through a review of the medical literature, the available information was examined, and the evidence found on the special management required by those patients was narratively synthesized, selecting the most representative decompensations within chronic disease that require emergency treatment.

Keywords: Blood products; Choque hipovolémico; Cirrosis descompensada; Decompensated cirrhosis; Encefalopatía hepática; Fluid therapy; Fluido terapia; Hemoderivados; Hepatic encephalopathy; Hypovolemic shock; Sepsis.

Publication types

  • Review

MeSH terms

  • Critical Illness
  • Emergencies
  • Hepatic Encephalopathy* / therapy
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / therapy