Biomaterial Database

Difficult management problems in fulminant hepatic failure. 1993

S J Muñoz

Department of Medicine, Jefferson Medical College, Philadelphia, Pennsylvania 19107.

The management of each FHF patient offers valuable opportunities to learn about the disease process, but the severity of this illness leaves little room for mishaps or omissions. FHF is a true medical emergency, like cardiogenic shock or acute renal failure. Hepatologists and transplant surgeons should train and teach their team, including ICU staff and house officers, in the basic aspects of FHF management. Furthermore, we strongly favor the creation of "FHF groups" in transplantation centers frequently caring for FHF patients. This group brings together hepatologists, transplant surgeons, ICU staff, nurses, neurologists, transplant coordinators, social workers, and others to design an FHF management protocol, periodically update and refine it, and develop a local consensus on the management of the many issues surrounding the care of the patient with FHF.

UI	MeSH Term	Description	Entries
D006501	Hepatic Encephalopathy	A syndrome characterized by central nervous system dysfunction in association with LIVER FAILURE, including portal-systemic shunts. Clinical features include lethargy and CONFUSION (frequently progressing to COMA); ASTERIXIS; NYSTAGMUS, PATHOLOGIC; brisk oculovestibular reflexes; decorticate and decerebrate posturing; MUSCLE SPASTICITY; and bilateral extensor plantar reflexes (see REFLEX, BABINSKI). ELECTROENCEPHALOGRAPHY may demonstrate triphasic waves. (From Adams et al., Principles of Neurology, 6th ed, pp1117-20; Plum & Posner, Diagnosis of Stupor and Coma, 3rd ed, p222-5)	Encephalopathy, Hepatic,Portosystemic Encephalopathy,Encephalopathy, Hepatocerebral,Encephalopathy, Portal-Systemic,Encephalopathy, Portosystemic,Fulminant Hepatic Failure with Cerebral Edema,Hepatic Coma,Hepatic Stupor,Hepatocerebral Encephalopathy,Portal-Systemic Encephalopathy,Coma, Hepatic,Comas, Hepatic,Encephalopathies, Hepatic,Encephalopathies, Hepatocerebral,Encephalopathies, Portal-Systemic,Encephalopathies, Portosystemic,Encephalopathy, Portal Systemic,Hepatic Comas,Hepatic Encephalopathies,Hepatic Stupors,Hepatocerebral Encephalopathies,Portal Systemic Encephalopathy,Portal-Systemic Encephalopathies,Portosystemic Encephalopathies,Stupor, Hepatic,Stupors, Hepatic
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man