Alcoholic Hepatitis - Management Algorithm
Assess Eligibility ...
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Description

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 

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Contributed by

Dr. Gerald Diaz
@GeraldMD
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:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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