肝衰竭的定义●肝损伤驱动的多器官损伤或衰竭，短期有较高病死率。·根据既往肝脏疾病谱和疾病进展速度，分急性肝衰竭、慢加急性肝衰竭、慢性肝衰竭
肝衰竭的病程分类定义命名病死率两周内出现2°以上肝性脑病为特征的肝衰急性起病、>50%（4周）急性肝衰竭竭。>15%（4周）慢加急性肝衰竭在慢性肝病基础上，4周内出现急性肝衰竭失代偿。>10%（1年）慢性肝衰竭在肝硬化基础上，出现慢性肝功能失代偿。EOOa
Hepatic encephalopathyCerebral edemaIntracranial hypertensionLungsHeartAcutelung injuryHigryoutput stateAcuterespiratorydistresssyndromeFrequent subclinicalmyocardial injuryLiverPancreasLoss.ofmetabolicfunctionPancreatitis,particularlynDecreased:acetaminophen-related diseaseGluconeogenesis-hypoglycemiaLactateclearance-lacticacidosisAdrenal glandAmmoniaclearance-+hyperammonemiaSynthetic capacity+coagulopathyInadequateglucocorticoid productioncontributing to hypotensionKidneyBonemarrowFrequent dysfunction orfailureFrequentsuppression,particulayin viral and seronegativediseasePortal hypertensionMaybe prorminent in subacute diseaseand confused with chronic liver diseaseCirculatingleukocytesImpairedfunction, with immunoparesisSystemic inflammatory responsecontributingto high risk of sepsisHighenergy expenditure orrateofcatabolism800
多器官损伤衰竭的定义器官衰竭（损伤）指标界值（常用）肝总胆红素>85umol/L凝血>1.5INR肾脏肌酐>133umol/L或升高50%脑脑病脑病呼吸氧合指数<300或呼吸支持循环平均动脉压≤70mmHg或升压药BOOtE
发病机制胆红素升高胆红素的代谢途径肝衰竭时的红细胞破坏肝衰竭时的肝细胞及胆管细胞损伤E200