Liver failure
Criteria that indicate liver failure following unintentional paracetamol poisoning, and necessitate discussion with a liver transplant unit, include any of the following1:
- INR higher than 3.0 at 48 hours after ingestion, or higher than 4.5 at any time after ingestion
- oliguria or serum creatinine concentration higher than 200 micromol/L
- persistent acidosis (pH less than 7.3) or blood lactate concentration higher than 3 mmol/L
- systolic hypotension with blood pressure less than 80 mmHg despite resuscitation
- hypoglycaemia
- severe thrombocytopenia
- encephalopathy
- altered conscious state without other sedative co-ingestion.