Knowledge Portal
Decompensated cirrhosis
Decompensated cirrhosis is marked by ascites, hepatic encephalopathy, variceal bleeding or jaundice and represents a major change in prognosis. An acute admission should prompt a structured search for infection, bleeding, alcohol-associated hepatitis, portal vein thrombosis, drug toxicity and other precipitants. Early management combines treatment of the trigger with careful fluid, albumin and diuretic decisions, complication-specific therapy, medication review, nutrition, and repeated assessment for ACLF and transplant referral.
Key information
Guidelines and position statements
Relevant clinical practice guidelines, practice guidance, consensus statements and position papers from professional bodies and expert groups.
Decompensated cirrhosis: an update of the BSG/BASL admission care bundle
BSG/BASL · care bundle · 2025
A bedside-focused admission bundle for the first hours of care, with an accompanying explanatory review.
Open resource →EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis
EASL · guideline · 2018
The core European guidance on ascites, infection, kidney injury, encephalopathy and advanced disease.
Open resource →Further context
Other useful resources
Selected review articles, practical explainers, expert discussions, reference sites and e-learning from established providers.
Management of acute decompensated cirrhosis
Mansour D. Clinical Medicine. 2025;25:100534.
A concise and practical review of the initial assessment, care bundle and common complications of an acute admission.
Open resource →Advances in the management of complications from cirrhosis
Singh J, Ebaid M, Saab S. Gastroenterology Report. 2024;12:goae072.
A broad open-access update spanning ascites, infection, encephalopathy, portal hypertension and renal dysfunction.
Open resource →Recent advances in the prevention and treatment of decompensated cirrhosis and ACLF and the role of biomarkers
Trebicka J, Hernaez R, Shawcross DL, Gerbes AL. Gut. 2024;73(6):1015–1024.
A detailed review of disease trajectory, prevention, emerging therapies and the evolving role of biomarkers.
Open resource →Cirrhosis & Chronic Liver Failure
Critical Care Reviews · curated review collection
A maintained collection of ICU-relevant reviews organised by complication and treatment.
Open resource →Acute decompensation of chronic end-stage liver disease
Deranged Physiology · ICU revision chapter · updated 2025
A detailed critical-care chapter on physiology, precipitants, organ failure and practical management.
Open resource →