End Organs Failure in Liver Cirrhotic Patients in Intensive Care Unit

Abstract

Liver cirrhosis can lead to a clinical state of liver failure, which can exacerbate through the course of the disease. New therapies aimed to control the diverse etiologies are now more effective, although the disease may result in advanced stages of liver failure, where liver transplantation remains the most effective treatment. The extended lifespan of these patients and the extended possibilities of liver support devices make their admission to an intensive care unit more probable. Different pathophysiological alterations present in liver cirrhotic patients make them need ICU admission, particularly cardiovascular, but also renal, coagulopathic, and encephalopathic. The ICU physician must be familiarized with the complex alterations in physiological systems related to liver cirrhosis. Cardiocirculatory dysfunction is present previous to the decompensating end-stage liver disease and is frequently unrecognized. Cirrhotic cardiomyopathy is a novel clinical condition that can aggravate the hemodynamic condition and/or support. Although there are no standard accepted diagnostic methods, echocardiography can be quite useful. Renal disease and pulmonary disease are also subject to special conditioning in liver cirrhosis. Diagnost