MODERN PRINCIPLES OF INTENSIVE MANAGEMENT OF PORTAL HYPERTENSION AND ITS COMPLICATIONS IN LIVER CIRRHOSIS

Portal hypertension represents the central hemodynamic disorder underlying decompensation in liver cirrhosis and is responsible for the majority of life-threatening complications, including variceal hemorrhage, ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, hepatic encephalopathy, and acute-on-chronic liver failure. Over the last two decades, advances in the understanding of intrahepatic resistance, splanchnic vasodilation, systemic inflammation, and circulatory dysfunction have fundamentally reshaped the intensive management paradigm. Contemporary strategies emphasize early identification of clinically significant portal hypertension, hemodynamic-guided therapy, pre-emptive transjugular intrahepatic portosystemic shunt placement in selected high-risk patients, rational albumin administration, vasoactive pharmacotherapy, antibiotic prophylaxis, and structured critical care algorithms. The present article synthesizes current scientific evidence within the IMRAD framework, highlighting modern principles of intensive management of portal hypertension in cirrhosis. Special attention is devoted to early intervention strategies, multidisciplinary coordination, individualized risk stratification, and integration of transplant evaluation. The findings indicate that timely hemodynamic control, infection prevention, and organ support significantly improve short-term survival and may alter the natural course of decompensated cirrhosis.