Clinical and paraclinical characteristics and treatment outcomes of patients with acute liver failure at the Poison Control Center of Bach Mai Hospital in 2020 - 2021 - 10

2

I. Diagnosis

1. Definitive diagnosis:… ……………………………………………………. 2. Diagnosis of the cause: …………………………....……………..………

II. Clinical and paraclinical symptoms


CLINICAL SYMPTOMS


Whole body

Glasgow Perception: (points)

Heaviest

Discharged from hospital



Pulse (beats/minute)



Breathing rate (times/minute)



Blood pressure (mmHg)



Temperature (degrees C)




1. Yes

2. No

Subcutaneous hemorrhage



Pale mucous membranes



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Clinical and paraclinical characteristics and treatment outcomes of patients with acute liver failure at the Poison Control Center of Bach Mai Hospital in 2020 - 2021 - 10

Mucosal jaundice



Ascites



Phew



Peripheral lymph nodes



Enlarged thyroid




Nerve


Clinical grading of hepatic encephalopathy

Degree 0

Level 1

Level 2

Level 3

Level 4


Digestion


1. Yes

2. No

Anorexia



Diarrhea or constipation



Nausea and vomiting



Vomiting blood



Bloody stools (black/red)



Right hypochondriac pain




Respiratory and cardiovascular

Chest pain



Shortness of breath



Oxygen breathing



Ventilator support




Abnormal rales



Pleural effusion



Arrhythmia



Abnormal heart sounds




Kidney


Urine volume

RIFLE:

R

I

F

L

PARACLINICAL RESULTS OF THE PATIENT


Test name

Test results by stage



The heaviest moment

Time of discharge


Arterial blood gas

PH




Lactate



mmol/L

Pa O2



mm Hg

PaCO2



mm Hg

HCO3




BEIGE




Electrolyte chart

Na+



mmol/L




mmol/L

Cl-



mmol/L

Blood formula

HC salary



T/L

Hemoglobin



g/L

Hematocrit



L/L

Platelet count



G/L

Platelet count



G/L

Number of BCTT



G/L

Lymphocyte count



G/L

Hemostasis

PTs



second

PTb/c



%

INR




Fibrinogen



g/l

APTTs



second

APTT (b/c)




D-dimer



mg/L

Blood chemistry

NH3



µmol/L

Urea



mmol/L

K+



µmol/L

Blood glucose



mmol/L

Bilirubin City



µmol/L

total bilirubin



µmol/L

LDH



U/L

ALP



U/L

AST



U/L

ALT



U/L

CK



U/L

GGT



U/L

Blood albumin



mmol/L

Procalcitonin



ng/mL

CRP



mg/L

Creatinine

III. Treatment

1. Treatment method:


Method

Have

Are not

Continuous venovenous hemofiltration (CVVH)



Continuous venovenous dialysis – ultrafiltration (CVVHDF)



Plasma exchange (PEX)

1. Routine



2. High volume



Anti-cerebral edema



Ventilator





Continuous venovenous hemofiltration (CVVH)

CVVH filter





Anticoagulants





Filtrate volume





Filter time





Plasma exchange (PEX): 1. Routine, 2. Aggressive, 3. High volume

PEX times





PEX Type





Anticoagulants





Plasma volume replaced in one PEX session





PEX Time





Use high dose corticosteroids

2. Treatment results

Relief, remission (clinical symptoms improved, INR test, prothrombin ratio, total bilirubin, ALT recovered)

Death (patient dies in hospital or asks to go home)

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