Hépato-Gastro & Oncologie Digestive
MENUManagement of critically-ill cirrhotic patients: transfer in intensive care unit or stop of care? Volume 20, issue 2, Février 2013
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- Key words: severe cirrhosis, reanimation, limiting and stopping active treatments
- DOI : 10.1684/hpg.2013.0839
- Page(s) : 133-40
- Published in: 2013
Cirrhosis is an independent prognostic factor for mortality in Intensive Care Unit (ICU). The improved management of acute complications of cirrhosis and a “fast tracking” access to liver transplantation are the keystones of reflection in the setting of invasive acute care. ICU admission is a multiparametric decision taking into account patient related factors, type of complications, intensive care scores and the existence of a therapeutical project. The decision between active resuscitation or withholding and withdrawal of life-sustaining treatment in critically-ill cirrhotic patient is difficult to make. In fact, the occurrence of a complication in these patients is often a turning point in the natural history and often leads to multi-organ failure. These procedures of withholding and withdrawal of life-sustaining treatment regulated by law have been developed to address these difficult ethical questions. The hepato-gastroenterologist plays a central role in this multidisciplinary reflection.