TY  - CHAP
M1  - Book, Section
TI  - Chapter 84. Management of the Patient with Cirrhosis
A1  - Satoskar, Rohit
A1  - Rubin, David T.
A2  - Hall, Jesse B.
A2  - Schmidt, Gregory A.
A2  - Wood, Lawrence D.H.
PY  - 2005
T2  - Principles of Critical Care, 3e
AB  - Patients  with  cirrhosis  admitted  to  the  ICU  are  at  risk  of  death  due  not  only  to  liver  disease,  but  also  due  to  the  many  complications  to  which  such  patients  are  at  risk.Worsening  encephalopathy  and  loss  of  the  gag  reflex  are  indications  for  elective  intubation  in  order  to  forestall  potentially  catastrophic  aspiration  or  respiratory  arrest.Invasive  procedures  carry  extra  risk  in  cirrhotics.  When  a  procedure  must  be  performed,  care  should  be  taken  to  minimize  the  likelihood  of  hemorrhagic  complications.Spontaneous  bacterial  peritonitis  should  be  considered  and  excluded  in  all  cirrhotics  with  fever,  encephalopathy,  abdominal  pain,  or  sepsis.Neomycin  and  metronidazole  are  superior  to  lactulose  for  the  treatment  of  hepatic  encephalopathy.The  MELD  score  is  a  reliable  method  for  predicting  3-month  mortality  and  is  currently  used  to  determine  transplant  status.Transplant  candidates  who  are  deteriorating  from  chronic  liver  disease  or  its  complications  should  be  transferred  to  a  transplant  center  for  management.  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2021/03/08
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=2296455
ER  -