Pediatric Acute Liver Failure: Etiologies, Intensive Care Management, and Prognostic Trends in a Tertiary Center Üçüncü Basamak Bir Merkezde Pediyatrik Akut Karaciğer Yetmezliği: Etiyoloji, Yoğun Bakım Yaklaşımı ve Prognoz

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Aycan F., KENDİRLİ T., Gün E., Botan E., KULOĞLU Z., TUNA KIRSAÇLIOĞLU C., ...Daha Fazla

Journal of Pediatric Emergency and Intensive Care Medicine (Turkey), cilt.13, sa.1, ss.39-46, 2026 (ESCI, Scopus, TRDizin) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 13 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.4274/cayd.galenos.2025.46503
  • Dergi Adı: Journal of Pediatric Emergency and Intensive Care Medicine (Turkey)
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.39-46
  • Anahtar Kelimeler: intensive care, liver transplantation, Pediatric acute liver failure, plasma exchange, prognosis
  • Ankara Üniversitesi Adresli: Evet

Özet

Introduction: Pediatric acute liver failure (PALF) is a life-threatening multisystem disorder characterized by rapid hepatic dysfunction. This study aimed to describe the etiologies, intensive care management, and outcomes of children with PALF admitted to a tertiary pediatric intensive care unit. Methods: We retrospectively reviewed 53 children with PALF admitted to our pediatric intensive care unit between January 2014 and December 2019. Demographic characteristics, etiology, intensive care interventions, and clinical outcomes were analyzed. Results: Toxic or drug-induced causes (43.4%) and indeterminate etiologies (32.1%) were most frequent. Twenty patients (37.7%) required invasive mechanical ventilation, 22 (41.5%) underwent plasma exchange, 11 (20.8%) received continuous renal replacement therapy, and 7 (13.2%) underwent liver transplantation. The mean pediatric intensive care unit stay was 7.4±9.0 days. Patients with toxic/drug-induced PALF required fewer interventions and had lower sepsis rates than those with other etiologies (p<0.01). Conclusion: Early recognition and comprehensive supportive care improve outcomes in children with PALF. Toxic or drug-induced PALF is associated with a milder clinical course. Continuous assessment of prognostic indicators is essential to guide management and decisions regarding liver transplantation.