Title: Acetaminophen Toxicity - When Should I Consider Liver Transplant?
题目：对乙酰氨基酚中毒－什么时候需要考虑肝移植？
Author 作者: Fermin Barrueto

If you are working in a community hospital and have an acetaminophen overdose, one of the criteria to transfer the patient to a tertiary care center is presence of the King's College Criteria.
如果你的工作在地方医院，接诊一个乙酰氨基酚过量的病人，将病人转移至三级医疗中心的标准之一是King College标准。
The below is taken from下面资料来源于mdcalc.com -  http://www.mdcalc.com/kings-college-criteria-for-acetaminophen-toxicity/
Each one is assigned points and can be prognostic for severe toxicity and need for transplant. The lactate and phosphorus are new ones and have modified the criteria. Phosphorus is utilized to create glycogen. If the liver is injured and trying to heal, your phosphorus will be low (good). If the liver is injured and unable to repair itself the phosphorus will be high (bad). This single test has an excellent prognostic ability.
每一个指标有一个分数，可以用来判断严重中毒和需要移植的预后。乳酸和磷是新的已修改后的指标。糖原的形成需要磷。如果肝脏受伤，如有愈合倾向，磷会低（好现象）。如果肝脏受伤而无法自我修复时，磷会高（坏现象）。这种单一的检查是一个很好的预测预后的指标。
Lactate > 3.5 mg/dL (0.39 mmol/L) 4 hrs after early fluid resuscitation?
早期液体复苏4小时后，乳酸> 3.5 mg/dL (0.39 mmol/L)
pH < 7.30 or lactate > 3 mg/dL (0.33 mmol/L) after full fluid resuscitation at 12 hours
在液体复苏12小时后，pH< 7.30或乳酸> 3 mg/dL (0.33 mmol/L)
INR > 6.5 (PTT > 100s)

Creatinine > 3.4 mg/dL (300 µmol/L)
肌酐> 3.4 mg/dL（300 µmol/L)
Phosphorus > 3.75 mg/dL (1.2 mmol/L) at 48 hours
48小时后磷 > 3.75 mg/dL (1.2 mmol/L)