This review examined the burden of alcohol-related liver disease (ALD) in the intensive care unit, which is increasing, and whether scoring systems can assist in judging prognosis. Embase, Medline and internet databases were searched for relevant articles whose quality was then scored using the Centre for Evidence-Based Medicine's (CEBM) critical appraisal tool. Unit mortality of patients with ALD admitted to intensive care in these studies was between 40–50%. In comparison with liver-specific prognostic scoring, physiological scoring systems discriminated better between survivors and non-survivors. This is likely to be a reflection of the fact that patients with ALD in intensive care tend to die of multi-organ failure rather than isolated acute liver failure.

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Central venous cannulation is commonly undertaken by a range of specialties in diverse clinical settings. Central veins may be cannulated by the landmark, ultrasound-guided or open surgical cut-down techniques. Complications of central venous catheter (CVC) insertion are common and may lead to significant morbidity and very occasional mortality. Two-dimensional ultrasound-guided central venous catheter placement has been shown by randomized controlled trials to be superior to the landmark technique. It reduces both the number of needle passes required for successful placement and the incidence of complications. Constant needle-tip visualization is a challenge for the novice operator. The National Institute of Clinical Excellence (NICE) recommends that following appropriate training, clinicians should use ultrasound wherever practical in both elective and emergency internal jugular vein catheterization.