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Acetaminophen poisoning: an update for the intensivist Dargan PI; Jones ALCrit Care 2002[Apr]; 6 (2): 108-10Acetaminophen overdose is common and can result from deliberate/nonstaggered or accidental/staggered ingestion. Patients presenting within 24 h of an acetaminophen overdose can safely be managed on medical wards. Early management of nonstaggered overdose is guided by the plasma acetaminophen concentration, whereas management of accidental/staggered ingestion is guided by ingested dose. Ingested dose and time from ingestion to presentation are important prognostic factors in accidental/staggered ingestion. Acetaminophen-induced acute liver failure (ALF) requires meticulous supportive care in an intensive care unit (ICU), with early identification and transfer of patients who are likely to require liver transplantation to a specialist liver centre. The modified King's College Hospital criteria (incorporating lactate into the traditional criteria) represent the best tool for identifying patients who require transplantation.|*Critical Care[MESH]|Acetaminophen/blood/*poisoning[MESH]|Acetylcysteine/*therapeutic use[MESH]|Analgesics, Non-Narcotic/blood/*poisoning[MESH]|Chemical and Drug Induced Liver Injury/*etiology/surgery[MESH]|Humans[MESH]|Liver Transplantation[MESH]|Prognosis[MESH] |
