Speakers
Dr Tasneem Pirani
Dr Ned (Edward) Gilbert-Kawai
Stream 3
The prevalence of chronic liver disease is increasing and associated with a significant mortality mainly as a result of the development of cirrhosis-related complications (ascites, variceal bleeding, hepatic encephalopathy, kidney dysfunction and infections) and acute-on-chronic liver failure.
These complications increasingly pose a significant challenge for all intensive care units from recognition of the condition, providing appropriate treatments and identifying who would best benefit from critical care interventions or referral to specialist centres. The aim of this session is to provide an insight on the determinants of a good outcome for ACLF and thereby help with decision making.
The session will also provide general intensivists with evidence-based management tips for common complications of variceal bleeding and hepatic encephalopathy while dispelling misconceptions. Guidance on when to refer patients to specialist centres will also be covered.
Management of the complications of severe acute pancreatitis in the ICU is complex and requires close MDT interaction. Current evidence for the treatments adopted will be covered together with any updates in outcome and prognostic data.
Learning objectives
1) How to use the available prognostic scores and updated outcome data in management of patients with ACLF
2) Evidence based treatment algorithms for variceal bleeding and hepatic encephalopathy in the ICU
3) How does the current evidence base help with critical care management of the complications of pancreatitis
Chaired by Tasneem Pirani, King’s College Hospital
Mark McPhail, King’s College Hospital and King’s College London ACLF: who should I admit, current outcomes, the value of prognostic scores and when to use them.
Clare Morkane, Royal Free Hospital: How I manage complex variceal bleeding and hepatic encephalopathy in the ICU
Ned Gilbert-Kwai, Royal Liverpool & Broadgreen University Hospital: The management of pancreatitis in critical care – is there anything new?
Completed dual training in hepatology and intensive care medicine in some of London’s major teaching hospitals.
Works as a critical care consultant at King’s College Hospital across both general intensive care and liver intensive care. Is currently the Clinical Lead for the King’s Liver Intensive Therapy Unit, which has a long history of spearheading research and innovation in the management of complex patients with acute liver failure and chronic liver disease. Her areas of specialist interest include pregnancy related acute liver failure, acute on chronic liver failure, use of extracorporeal support in acute and chronic liver failure as well as management of systemic diseases affecting the liver such as HLH and haematological malignancies
Ned Gilbert-Kawai is a Consultant in Critical Care Medicine & Anaesthesia at The Royal Liverpool University Hospital NHS Foundation Trust. Ned completed his PhD at University College London on the effect of hypoxia on microcirculation and then undertook a Masters in Genomic Medicine at Imperial College London. He was the Chief Scientific Officer for the Xtreme Everest 2 expedition (UCL Centre for Altitude, Space and Extreme Environment (CASE) Medicine, 2013), and has since maintained an interest in both cardiovascular physiology and genomic medicine. He is an associate editor of the Journal of Intensive Care Society and an examiner at the European Society of Intensive Care Medicine Exams.
Clare is a Consultant Intensivist and Anaesthetist at the Royal Free Hospital, London. She trained in Cardiff and London and spent one year as a visiting Attending Anesthesiologist at the University of California, San Francisco. She completed an MD(res) focussed on prehabilitation for patients undergoing liver transplantation and complex major vascular surgery.
She has a specialist interest in liver intensive care and the perioperative management of patients undergoing complex major surgery.