Diagnosis and treatment of acute liver failure in children

The article was professionally consulted by Doctor Ho Thi Anh Thu - Neonatologist - Pediatrics - Neonatology Department - Vinmec Nha Trang International General Hospital. He graduated as a Resident Doctor of Pediatrics at the University of Medicine and Pharmacy in Ho Chi Minh City. Ho Chi Minh City, has strengths in the treatment of general pediatric pathologies such as pneumonia, enteritis, asthma, allergies, eczema.

Acute liver failure is relatively rare in children. However, once this disease occurs in children, it is often severe and carries a very high risk of death. Therefore, the treatment of acute liver failure in children should be carried out early, quickly and according to the doctor's schedule.

Acute liver failure or fulminant hepatitis is understood as a type of liver disease with loss of function, because liver cells are damaged and die in large numbers and over a large period of time. This disease is accompanied by encephalopathy that occurs within 8 weeks of the onset of liver disease.
Acute liver failure has many causes, which can be due to infection, shock and multiple organ failure or liver failure due to autoimmune hepatitis, liver failure in systemic diseases, liver failure due to drugs or poisoning or disorders metabolic disorders, rare diseases...

2.1 Clinical diagnosis The clinical diagnosis is made by the doctor based on the signs in the child such as jaundice, mucosal and gastrointestinal bleeding, edema, ascites.
The final stage of acute liver failure is hepatic coma. Symptoms of hepatic coma in young children are vomiting, poor feeding, convulsions, somnolence, lethargy...; in older children is agitation, convulsions, lethargy, dancing,...
2.2 Subclinical diagnosis When a child is suspected of having acute liver failure, the doctor will order tests, including :
General tests on hematology, kidney function, blood clotting, electrolyte abnormalities; Specific for the liver: inflammatory reactions, liver enzymes; Diagnostic test of the root cause. From the symptoms along with the test results, the doctors will confirm the diagnosis of whether the child has acute liver failure or not.

From the above diagnoses, doctors and experts will base on the child's condition to give appropriate treatment directions, bringing the best effect for the child. Liver transplantation is known to be the best treatment for acute liver failure, but in some cases, medication will be indicated. During treatment, unless absolutely necessary, doctors note that liver biopsy is contraindicated due to abnormalities in blood clotting.
Some treatment methods for acute liver failure can be mentioned as follows:
3.1 Drug treatment When children have to use drugs for treatment, it means that the cause of acute liver failure is due to cardiovascular conditions or other effects. side effects caused by the drug. Therefore, parents are advised by doctors to prescribe medicine for young children. This will improve liver health for the pediatric patient.
A healthy lifestyle, healthy eating, using prescription drugs to help improve the body's metabolism are also good measures to improve the child's liver condition.

3.2 Liver Transplant As mentioned above, liver transplantation will be the most effective, advanced treatment for patients with acute liver failure. According to research, 40% of children with acute liver failure need a liver transplant to continue their life.
However, it is also necessary to rely on many factors for the doctor to decide whether to give a liver transplant to a child, for example:
Causes of the disease; High success rate when performing transplants; Multiple organ failure or encephalopathy is reversible after surgery. 3.3 Treatment of coagulopathy Treatment of coagulopathy is by infusion of fresh plasma 10-15ml/kg/time when there is clinical bleeding. Note may cause volume overload. Use vitamin K1 5-10mg/day for up to 3 days.
3.4 Support for care and treatment This method is used with cases where the child can recover on his own when the symptoms are completely treated. Part of it is also based on the general condition of the child and the underlying liver disease, so it will automatically recover. The majority of these cases had liver failure in be.
Children, if unfortunately suffering from acute liver failure, will face serious complications affecting their health and development later on. Therefore, when seeing a child with suspicious signs of acute liver failure, parents should take the child to the doctor as soon as possible to accurately determine the child's health status, thereby taking timely intervention measures.
As a key area of ​​Vinmec Health system, Pediatrics Department always brings satisfaction to customers and is highly appreciated by industry experts with:
Gathering a team of top doctors and nurses in Pediatrics : consists of leading experts with high professional qualifications (professors, associate professors, doctorates, masters), experienced, worked at major hospitals such as Bach Mai, 108.. Doctors All doctors are well-trained, professional, conscientious, knowledgeable about young psychology. In addition to domestic pediatric specialists, the Department of Pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) who are always pioneers in applying the latest and most effective treatment regimens. . Comprehensive services: In the field of Pediatrics, Vinmec provides a series of continuous medical examination and treatment services from Newborn to Pediatric and Vaccine,... according to international standards to help parents take care of their baby's health from birth to childhood. from birth to adulthood Specialized techniques: Vinmec has successfully deployed many specialized techniques to make the treatment of difficult diseases in Pediatrics more effective: neurosurgery - skull surgery, stem cell transplantation. blood in cancer treatment. Professional care: In addition to understanding children's psychology, Vinmec also pays special attention to the children's play space, helping them to have fun and get used to the hospital's environment, cooperate in treatment, improve the efficiency of medical treatment.