1. Identify and treat cause. Where possible, discontinue any drug that could be implicated. If extrahepatic, consider percutaneous transhepatic drainage, bile duct stenting or, rarely, surgery.

2. Liver biopsy is rarely necessary in a jaundiced ICU patient unless the diagnosis is unknown and the possibility exists of liver involvement in the underlying pathology, e.g. malignancy.

3. Non-obstructive jaundice usually settles with conservative management as the patient recovers.

4. An antihistamine and topical calamine lotion may provide symptomatic relief for pruritus if troublesome. Cholestyramine 4g tds PO may be helpful in obstructive jaundice.

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