To improve care pathways for cirrhotic patients, new national information and communication network structures need to be established, delegates at the recently-held British Society of Gastroenterology Annual Meeting were told.
He addressed the meeting, held at the International Convention Centre, Birmingham, on “Liver cirrhosis and access to ICU… who should go and who will survive?” and said that thinking on accommodating cirrhotic patients in intensive care departments was “stuck in a rut”. Dr O’Brien contended that “the time has come to do something different”, and that improved dialogue between specialists in liver disease and their counterparts in intensive care was necessary.
There needed to be a clearer view of which cirrhotic patients should have access to intensive care. Cirrhotic patients such as those who were transplant candidates, those with variceal bleeding, and those requiring ventilation following single organ failure, could significantly benefit from intensive care medicine, he said, adding that daily review of these patients in intesive care units was essential, as was a continuous monitoring of the value of ICU treatment to the patients.
Dr O’Brien said responsibility for determining the treatment plan for cirrhotic patients needed to rest with specialists in liver disease, continuing: “We go to ICU to ask for their opinion – but these are our patients, and we should not put the burden of responsibility on the ICU team.”
