The management of hepatic encephalopathy and cerebral oedema in acute liver failure

Abstract

Acute liver failure is a term that first became established in the 1960s to describe a rare clinical syndrome that is characterized by severe hepatocyte injury, jaundice and hepatic encephalopathy, usually in the absence of pre-existing chronic liver disease. Acute liver failure has a variety of aetiologies. It is associated with high mortality and morbidity. While acute liver failure is a disease of multi-organ failure, all patients with acute liver failure will have some degree of hepatic encephalopathy, which, when advanced, is associated with a high incidence of cerebral oedema and intracranial hypertension. When these symptoms are combined with other failing bodily systems, this group of patients are extremely challenging to manage. This article presents an overview of hepatic encephalopathy and the management of cerebral oedema in this group of patients, examining current medical and nursing strategies.