Abstract
Yellow fever (YF) has been a significant public health concern since its first description in the 15th centu-ry, affecting various critical periods throughout human history. It has caused incalculable suffering and indescribable misery among populations in the Americas, Europe (1). The management of multiple organ dysfunction, particularly acute liver failure secondary to YF in intensive care units (ICUs), requires a comprehensive, multidisciplinary, and aggressive approach aimed at stabilizing the patient, treating systemic complications, and, if necessary, preparing for liver transplantation (2). This protocol establishes the guidelines for the comprehensive management of adult patients with severe YF admit-ted to the ICU at Clínica Colsanitas. It includes clinical and paraclinical criteria for admission, addressing parameters of hepatic, renal, respiratory, cardiovascular, and neurological dysfunction. The therapeutic strategy encompasses continuous monitoring, personalized hemodynamic support, protective mechan-ical ventilation, renal replacement therapy, coagulopathy management guided by thromboelastography, and the use of intensive plasma exchange in selected cases. Additionally, metabolic, neurological, and nutritional support interventions are considered, as well as the evaluation for liver transplantation in exceptional situations.
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