Acute Liver Failure (Fulminant Hepatic Failure)


  • Intoxications
    • Acetaminophen Intoxication (see [[Acetaminophen Intoxication]])
    • Chlorinated Hydrocarbon Intoxication (see [[Hydrocarbons]]
    • Paraquat Intoxication (see [[Paraquat]]
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  • Advanced hepatic failure is accompanied by the development of coagulopathy
  • In patients with chronic hepatic failure, abnormal synthesis of multiple coagulation factors is often accompanied by thrombocytopenia, largely resulting from hypersplenism
  • In addition, these patients often have an increased likelihood of bleeding due to the presence of varices and/or portal gastropathy.
  • In acute hepatic failure, coagulopathy develops primarily due to reduced production of coagulation factors
  • As factor VII has a relatively short half-life in the circulation, a rising prothrombin time/INR is often an early finding in developing acute liver failure (and an early indication of hepatic recovery if it begins to fall)


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  • Treat [[Coagulopathy of Liver Failure]]


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