Many people have liver disease for a long time before coming into the hospital. Patients with liver disease in the ICU can be much sicker than others. ICU patients are very sick and may not live.
Why is liver disease serious?
Many body systems can have problems when a patient has liver disease. These include:
- Fluid in the belly that makes it hard to breathe (ascites)
- Fluid in the belly that becomes infected (bacterial peritonitis)
- Spread of infection (sepsis) and septic shock
- Confusion (hepatic encephalopathy)
- Bleeding from the stomach (GI bleed)
- Other bleeding problems because the liver can’t make the needed clotting factors
- Extra fluid in the lungs that makes it hard to breathe (pulmonary edema)
- Acute or chronic kidney failure.
How will ascites be treated in the ICU?
- Ascites can be very painful and make it hard to breathe
- A breathing machine may be needed
- Pain medicine is often needed
- Doctors can treat it by drawing out fluid from below the skin of the belly
- Fluid may come back very quickly after it is removed
- A protein called albumin is often given
- Some people need drugs to make more urine and help the kidneys
- Some people need tubes put in their liver to open up blood vessels
- If an infection occurs it may cause death
- Sometimes the infection goes into the blood
- Treatment is antibiotics
How will hepatic encephalopathy (HE) be treated in the ICU:
HE happens because the liver becomes too sick to remove toxins that harm the brain. Treatment will help clear toxins by having more bowel movements.
How will GI bleeding be treated?
- A GI bleed can lead to death from blood loss
- Treatment includes drugs and a tube that goes from the nose to the stomach
- Surgery may be needed to stop the bleeding
- Blood may be given to replace blood loss
How does bleeding in the body occur?
The liver can become too sick to make proteins that help the blood clot. This can lead to death because the body cannot stop the bleeding. Bleeding cannot always be stopped by giving blood.