1 rich Libsyn https://www.libsyn.com 90 600 In this episode, I walk through the real-world critical care management of acute decompensated alcohol-related liver disease, using a high-risk ICU case to anchor the discussion. The focus is on understanding the underlying physiology—portal hypertension, rebalanced haemostasis, hepatic encephalopathy, infection, and hepatorenal syndrome—and translating that physiology into clear first-hour priorities at the bedside. Listeners are guided through airway and circulatory decision-making, rational use of albumin, vasopressors, antibiotics, lactulose and rifaximin, and careful blood product transfusion, while avoiding common pitfalls such as reflexive FFP or over-resuscitation. The episode emphasises early recognition of red flags, the central role of infection as a precipitant, and the interconnected nature of multi-organ failure in acute-on-chronic liver disease, all framed within pragmatic UK ICU practice. The Critical Care Practitioner http://criticalcarepractitioner.libsyn.com/website <iframe title="Libsyn Player" style="border: none" src="//html5-player.libsyn.com/embed/episode/id/39659410/height/90/theme/custom/thumbnail/yes/direction/forward/render-playlist/no/custom-color/88AA3C/" height="90" width="600" scrolling="no" allowfullscreen webkitallowfullscreen mozallowfullscreen oallowfullscreen msallowfullscreen></iframe> https://assets.libsyn.com/secure/content/197281965