MODERN PRINCIPLES OF INTENSIVE MANAGEMENT OF PORTAL HYPERTENSION AND ITS COMPLICATIONS IN LIVER CIRRHOSIS
DOI:
https://doi.org/10.55640/Keywords:
liver cirrhosis, portal hypertension, variceal bleeding, ascites, hepatorenal syndrome, TIPS, albumin therapy, intensive care, acute-on-chronic liver failure.Abstract
Portal hypertension represents the central hemodynamic disorder underlying decompensation in liver cirrhosis and is responsible for the majority of life-threatening complications, including variceal hemorrhage, ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, hepatic encephalopathy, and acute-on-chronic liver failure. Over the last two decades, advances in the understanding of intrahepatic resistance, splanchnic vasodilation, systemic inflammation, and circulatory dysfunction have fundamentally reshaped the intensive management paradigm. Contemporary strategies emphasize early identification of clinically significant portal hypertension, hemodynamic-guided therapy, pre-emptive transjugular intrahepatic portosystemic shunt placement in selected high-risk patients, rational albumin administration, vasoactive pharmacotherapy, antibiotic prophylaxis, and structured critical care algorithms. The present article synthesizes current scientific evidence within the IMRAD framework, highlighting modern principles of intensive management of portal hypertension in cirrhosis. Special attention is devoted to early intervention strategies, multidisciplinary coordination, individualized risk stratification, and integration of transplant evaluation. The findings indicate that timely hemodynamic control, infection prevention, and organ support significantly improve short-term survival and may alter the natural course of decompensated cirrhosis.
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1.Bosch J., Abraldes J. G., Berzigotti A., García-Pagán J. C. The clinical use of HVPG measurements in chronic liver disease // Nature Reviews Gastroenterology & Hepatology. – 2009. – Vol. 6. – P. 573–582.
2.Garcia-Tsao G., Abraldes J. G., Berzigotti A., Bosch J. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management // Hepatology. – 2017. – Vol. 65, No. 1. – P. 310–335.
3.Villanueva C., Colomo A., Bosch A., et al. Transfusion strategies for acute upper gastrointestinal bleeding // New England Journal of Medicine. – 2013. – Vol. 368. – P. 11–21.
4.Ахроров, А. А., & Пулатова, Б., Назарова, Ш. (2021). Усовершенствование тактики хирургического лечения больных с травмой средней зоны лица. Медицина и инновации, 1(4), 199–204.
5.Ахроров, А.Ш. (2024). Одонтогенные инфекции головы и шеи. World Scientific Research Journal, 1 (Volume-25), 60–70.
6.Shavkatovich, A. A. (2023). Modern Aspects of Treatment of Odontogenic Sinusitis. Genius Repository, 25, 23–26.
7.Shavkatovich, A. A., & Davronovich, M. D. (2023). Peculiarities of the treatment algorithm for the congenital defect that crosses the palate. Intent Research Scientific Journal, 2, 101–107.
8.Ахроров, А.Ш., & Усмонов, Р.Ф. (2023). Лечения больных с травмой средней зоны лица путем виртуального моделирования. Образование, наука и инновационные идеи в мире, 13(6), 16–23.
9.АШ Ахроров (2024). FEATURES OF THE USE OF A BONE BLOCK TAKEN FROM THE ZONE OF THE ZYGOMATICAL-ALVEOLAR BUTTRESS. Web of Medicine: Journal of Medicine, Practice and Nursing, 2 (ISSN (E): 2938 …), (страницы указаны в исходных данных).
10.БАМ Ахроров Алишер Шавкатович, Усмонов Рахматилло Ф. (2024). Особенности применения костного блока, взятого из зоны скуло-альвеолярного контрфорса. Journal of New Century Innovations, 47, 149–157.
11.AA Shavkatovich (2024). New Technique for Gum Plastic Sugery with Single-Stage Implantation. Eurasian Scientific Herald, 1 (2795-7365), 8–12.
12.AA Shavkatovich, PB Juraxanovna (2021). Optimization Of Surgical Tactics For Treating Patients With Midrace Trauma. *The American Journal of Medical Sciences and Pharmaceutical Research*, 3(02), (страницы указаны в исходных данных).
13.Fernández J., Ruiz del Arbol L., Gómez C., et al. Norfloxacin vs ceftriaxone in the prophylaxis of infections in patients with advanced cirrhosis and hemorrhage // Gastroenterology. – 2006. – Vol. 131. – P. 1049–1056.
14.García-Pagán J. C., Caca K., Bureau C., et al. Early use of TIPS in patients with cirrhosis and variceal bleeding // New England Journal of Medicine. – 2010. – Vol. 362. – P. 2370–2379.
15.Caraceni P., Riggio O., Angeli P., et al. Long-term albumin administration in decompensated cirrhosis (ANSWER study) // The Lancet. – 2018. – Vol. 391. – P. 2417–2429.
16.Angeli P., Ginès P., Wong F., et al. Diagnosis and management of acute kidney injury in patients with cirrhosis // Journal of Hepatology. – 2015. – Vol. 62. – P. 968–974.
17.Schrier R. W., Arroyo V., Bernardi M., Epstein M., Henriksen J. H., Rodés J. Peripheral arterial vasodilation hypothesis: A proposal for the initiation of renal sodium and water retention in cirrhosis // Hepatology. – 1988. – Vol. 8. – P. 1151–1157.
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