The Emergency Medicine Approach to the Decompensating Cirrhotic Patient

Background: Cirrhosis is the 8th leading cause of death in the United State and has a variety of causes, most commonly Hepatitis C and alcohol. Liver fibrosis and nodule formation results in significant complications due to portal system hypertension. There are several deadly complications that emergency physicians must consider. Objective of the Review: Provide an evidence-based update for the resuscitation of Decompensating cirrhotic patients and an overview of cirrhosis complications. Discussion: Cirrhosis is a common condition in the U.S. and leads to several deadly complications including variceal hemorrhage, ascites, Spontaneous Bacterial Peritonitis (SBP), hepatic encephalopathy, hepatorenal syndrome, and hepatopulmonary syndrome. Key resuscitation techniques and care of the complications of cirrhosis can reduce morbidity and mortality Conclusions: Decompensating cirrhotic requires extensive resuscitation, and new techniques for intubation and restoring circulation show promise in reducing morbidity and mortality.