Tratamiento etiológico del Fallo Hepático Agudo
Etiologia Tratamiento
Acetaminofen  NAC oral 140 mg/kg/ carga y 40 mg/kg 4 horas
 NAC: 150 mg/kg/iv carga + 12.5 mg/kg 4 horas + 6 mg/kg/h
Amanita  Penicilina G 1 gr/kg/dia iv + NAC(=)
V.Herpes Simple  Acliclovir: 30 mg/kg/dia/iv
V. Hepatitis.B  Lamivudine 100-150 mg/dia/vo
Autoinmune H.  Metilprednisolona 60 mg/dia/iv
HELLP/FHA  Extracción del Feto

Referencias:

  • Smilkstein MJ, Knapp GL, Kulig KW, et al: Efficacy of oral N-acetylcysteine in the treatment of acetaminophen overdose. Analysis of the national multicenter study (1976 to 1985). N Engl J Med 1988; 319:1557–1562

  • Buckley NA, Whyte IM, O’Connell DL, et al: Oral or intravenous N-acetylcysteine: Which is the treatment of choice for acetaminophen (paracetamol) poisoning? J Toxicol Clin Toxicol 1999; 37:759–767

  • Smilkstein MJ, Bronstein AC, Linden C, et al: Acetaminophen overdose: A 48-hour intravenous N-acetylcysteine treatment protocol. Ann Emerg Med 1991; 20:1058–1063

  • Floersheim GL, Eberhard M, Tschumi P, et al: Effects of penicillin and silymarin on liver enzymes and blood clotting factors in dogs given a boiled preparation of Amanita phalloides. Toxicol Appl Pharmacol 1978; 46:455–462

  • Broussard CN, Aggarwal A, Lacey SR, et al: Mushroom poisoning—from diarrhea to liver transplantation. Am J Gastroenterol 2001; 96:3195–3198

  • Peters DJ, Greene WH, Ruggiero F, et al: Herpes simplex–induced fulminant hepatitis in adults: A call for empiric therapy. Dig Dis Sci 2000; 45:2399–2404

  •  Kessler WR, Cummings OW, Eckert G, et al: Fulminant hepatic failure as the initial presentation of acute autoimmune hepatitis. Clin Gastroenterol Hepatol 2004; 2: 625–631

  • Tillmann HL, Hadem J, Leifeld L, et al: Safety and efficacy of lamivudine in patients with severe acute or fulminant hepatitis B, a multicenter experience. J Viral Hepat 2006; 13:256–263

  •  Castro MA, Fassett MJ, Reynolds TB, et al: Reversible peripartum liver failure: A new perspective on the diagnosis, treatment, and cause of acute fatty liver of pregnancy, based on 28 consecutive cases. Am J Obstet Gynecol 1999; 181:389–395

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