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Acute Liver Failure - Coggle Diagram

- - - - Hepatitis A-E
    - - Paracetamol
    - - Primary/secondary
    - - Ischaemic/ Budd chari
    - - HELLP
      - Acute fatty liver of pregnancy
    - - Wilsons
    - - Seronegative
- - - - Glutathione
    - - NAPQI
    - - Alcohol
      - Enzyme inducers eg St Johns Wart
    - - Malnutrition
- - - - Mannitol/hypertonic saline
      - Barbituates
      - Indomethacin
    - - Aviod excessive PEEP to reduce hepatic pressure and ICP
      - Early intubation
    - - Terlipressin
      - Avoid excessive lactate load
    - - NAC
      - Laxido
    - - Na 145-150
      - RRT/ammonia clearance
      - High volume plasma exchange
    - - Coagulopathy correctction
      - TEG
- - - - Non-paracetamol induced ALF
        
        INR >6.5
        
        Or ANY three of
        
        Age <11 >40
        
        NonA/B hepatitis or idiosyncratic drug reaction
        
        Time of onset of jaundice to encephalopathy >7days eg not hyperacute
        
        Bilirubin >300
      - Paracetamol toxicity
        
        Or ALL three of
        
        INR>6.5
        
        Cret >300
        
        Grade 3/4 encephalopathy
        
        pH<7.3