End stage hepatic disease
Patient (condition)
 
Aliases:
End stage liver disease (ESLD)
Chronic liver disease (CLD)

Topic aliases are alternate phrasings for a particular topic.


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Check platelet count. Thrombocytopaenia may be present from splenomegaly secondary to portal hypertension.

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Sep 08, 2011
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Consider performing serum creatinine and urea to assess for renal impairment.

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Consider perfroming a serum sodium level to rule out hyponatremia

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Examination and Chest Xray may reveal pleural effusions.

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May have portal hypertension. Consider the presence of varices and risk of variceal bleeding.

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May have secondary pulmonary hypertension due to the reduced hepatic clearance of vasoactive substances produced in the splancnic bed. (bypassing liver via portosystemic shunt) refl.in/n

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If inserting nasogastric tube NGT, use cautious technique to prevent rupture of oesophageal varices

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Vitamin K deficiency is common due to malabsorption. Administer preoperative supplementation to improve liver production of clotting factors and reduce perioperative bleeding risk.

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24hrs prior to procedure. 1mg IV or 10mg orally. #ref
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At risk of high output cardiac failure from a reduction in SVR. This may be resistant to vasoconstrictors. #ref

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Consider performing a coagulation profile in patients undergoing surgical procedures. Patient is at risk of clotting factor deficiency and coagulopathy secondary to synthetic liver failure.

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Patients are at elevated risk of hemorrhage during intrabdominal
procedures from the rupture of portosystemic collateral vessels.

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Consider altered pharmacokinetics in a patient with reduced hepatic clearance, lower plasma protein binding capacity, and often, reduced renal and biliary excretion. #improve

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