Mitochondrial hepatopathy: Respiratory chain disorders- ‘breathing in and out of the liver’

Table 5 Management during evaluation in acute phase

Following thumb rules while attending to a patient with suspected mitochondrial disorder
Monitor closely for hypoglycemia and acidosis
Avoid lactated ringer’s solution for fluid administration: Worsens acidosis
Bicarbonate infusions as 1st line of defense
Avoid propofol for sedation/anesthesia
Avoid fasting > 12 h; avoid high rate glucose only infusions
Avoid drugs that are toxic to mitochondria: Chloramphenicol, valproate, aminoglycosides, phenytoin, carbamazapine, phenobarbital, statins, linezolid
Avoid drugs precipitating hepatopathy/liver dysfunction