Corey Diamond, PharmD
The Society of Critical Care Medicine (SCCM) has recently released the second part of their guidance on the management of acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) in the ICU.
Published in the May 2023 issue of Critical Care Medicine, the guideline—compiled by 27 experts—continues SCCM’s mission set out earlier in 2022. Their previously published recommendations focused on CV, hematological, pulmonary, renal, and endocrine/nutrition issues. This time, their guidance focuses on updates to ALF considerations in the setting of neurology, peri-transplant medicine, infectious disease, and gastroenterology.
Guideline structure
Part 2 of the SCCM’s guidance of ALF and ACLF segregates recommendations into four distinct subgroups: Neurology, peri-transplant, infectious diseases, and gastroenterology.
The authors present 28 recommendations on the management of ALF and ACLF in the ICU. Overall, they include 5 strong recommendations, 21 conditional recommendations, and 5 recommendations with insufficient evidence.
Below is a summary of the panel’s strong or conditional recommendations—those that have an evidence level of low or higher—that are pertinent to pharmacology. ■
The authors present 28 recommendations on the management of ALF and ACLF in the ICU.
