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Paracetamol ALF NAC Continuation — FRCA Final MCQ

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HardIntensive Care MedicineParacetamol ALF NAC ContinuationFRCA Final

Paracetamol ALF meeting King's College criteria. Which therapy should be continued until transplant?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — NAC IV infusion

NAC continues in established paracetamol ALF beyond standard 21h protocol. Improves hepatic perfusion, scavenges free radicals, improves transplant-free survival. Do NOT give FFP to correct INR — obscures the most important prognostic marker (serial INR trend).

Reference: NICE – 2023 – NG53 ALF; EASL – 2023