RT Book, Section A1 Sakaria, Sonali A1 Subramanian, Ram M. A2 Hall, Jesse B. A2 Schmidt, Gregory A. A2 Kress, John P. SR Print(0) ID 1107711952 T1 Management of the Patient With Cirrhosis T2 Principles of Critical Care, 4e YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071738811 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1107711952 RD 2024/03/29 AB Portal hypertension, resulting from increased intrahepatic resistance to portal flow and increased portal inflow, marks the transition from compensated to decompensated cirrhosis.The sequelae of portal hypertension affect each organ system, requiring multi-disciplinary management.Grades III and IV hepatic encephalopathy require immediate ICU transfer and elective intubation for airway protection.Pulmonary derangements resulting from portal hypertension may be severe and include hepatopulmonary syndrome, portopulmonary hypertension, and hepatic hydrothorax.Hepatorenal syndrome is a diagnosis of exclusion and is characterized by renal impairment in the setting of advanced liver disease, circulatory dysfunction, and increased activity of the renin-angiotensin system.SBP is a known precipitant of HRS, which is a cause of increased mortality in cirrhotic patients; therefore empiric antibiotic treatment is warranted in patients in whom the suspicion for SBP is high.Aggressive intravenous resuscitation, airway protection, and early endoscopic management of cirrhotic patients presenting with suspected variceal bleed is critical.