Treatment is mostly supportive and tailored towards the specific etiology
Early consideration regarding transporting patient to a transplant center given potential for rapid deterioration
Symptom specific supportive treatment options
Encephalopathy: consider lactulose of neomycin
Seizures: consider phenytoin over benzodiazepines (prevent benzodiazepine oversedation secondary to decreased<unk>  clearance)
Intracranial Hypertension: elevated head of bed, mannitol, short-term hyperventilation; hypothermia may be a bridge to transplant; no benefit from steroids
Coagulopathy
Prophylactic normalization of the INR is not necessary unless procedure (such as paracentesis) is planned; then can give Vitamin K
Recommend platelet transfusion to 10K for asymptomatic patients, and to 50-70K for patients undergoing invasive procedures
See Acetaminophen toxicity for specifics regarding treatment of acetaminophen toxicity
See Spontaneous Bacterial Peritonitis for specifics regarding diagnosis and treatment of SBP
Encephalopathy: consider lactulose of neomycin
Seizures: consider phenytoin over benzodiazepines (prevent benzodiazepine oversedation secondary to decreased<unk>  clearance)
Intracranial Hypertension: elevated head of bed, mannitol, short-term hyperventilation; hypothermia may be a bridge to transplant; no benefit from steroids
Coagulopathy
Prophylactic normalization of the INR is not necessary unless procedure (such as paracentesis) is planned; then can give Vitamin K
Recommend platelet transfusion to 10K for asymptomatic patients, and to 50-70K for patients undergoing invasive procedures
See Acetaminophen toxicity for specifics regarding treatment of acetaminophen toxicity
See Spontaneous Bacterial Peritonitis for specifics regarding diagnosis and treatment of SBP
Prophylactic normalization of the INR is not necessary unless procedure (such as paracentesis) is planned; then can give Vitamin K
Recommend platelet transfusion to 10K for asymptomatic patients, and to 50-70K for patients undergoing invasive procedures
Acute hepatic failure
Hypoglycemia
Acute hepatitis
Hypoxia
Adrenal crisis
Intracerebral hemorrhage or mass
Acute kidney injury
Meningitis/encephalitis