Alcoholic Hepatitis - Management Algorithm
Assess Eligibility ...

Alcoholic Hepatitis - Management Algorithm
Assess Eligibility for Treatment:
 - Maddrey Discriminant Function ≥ (or possibly MELD >20)
 - Obtain abdominal to exclude other causes of jaundice
 - Screen for infection with chest x-ray, blood, urine and ascites cultures
Assess for Contraindications to Treatment:
 - Acute kidney injury with serum creatinine >2.5 mg/dL
 - Uncontrolled upper gastrointestinal bQiing
 - Concomitant diseases including HBV. HCV, DILI, HCC, acute pancreatitis. HIV, TB
 - Multiorgan failure or shock
Eligible for Treatment:
 - Start prednisolone 40 mg daily or equivalent with or without IV N-acetylcysteine
 - Enteral nutrition goal of >21 kcal/kg
Use Lille model after 7 days of treatment:
 - If Lille < 0.45 continue prednisolone for 28 days
 - If Lille ≥ 0.45. stop prednisolone 

#Alcoholic #Hepatitis #Management #Algorithm #hepatology
Contributed by

Dr. Gerald Diaz
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: | Twitter:

Related content