Fig. 3.

Golden window in ACLF. ACLF is the state of acute inflammatory response with cytokine burst. The SIRS is a response to this inflammation and subsequent resolution of inflammation and recovery or persistence of inflammation (leading to Compensatory Anti-inflammatory Inflammatory Response Syndrome-CARS) and sepsis. Patients of ACLF in a period of 7 days develop SIRS (which can be infective or sterile) but both the things lead to complications and sepsis develops subsequently. This time period is the therapeutic Golden Window. SIRS needs consideration for organ support, antibiotics for occult sepsis and prioritization for definitive therapy, i.e., liver transplant