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Visualization and Analysis of Blood Flow and Oxygen Consumption in Hepatic Microcirculation: Application to an Acute Hepatitis Model
Published on: August 4, 2012
Hypoxic hepatopathy: pathophysiology and prognosis.
Richard Birrer1, Yasuharu Takuda, Tsuyoshi Takara
1Medicine, St. Joseph's University Medical Center, USA. rbbirrer@yahoo.com
Internal Medicine (Tokyo, Japan)
|July 20, 2007
Summary
Transient elevation of liver enzymes, often called "shock liver," can occur in patients without hypotension. This condition, now termed hypoxic hepatopathy, is linked to hypoxic states from various causes.
Area of Science:
- Critical care medicine
- Hepatology
- Pathophysiology
Background:
- Transient elevation of hepatic enzymes is observed in patients experiencing hypo-perfusion.
- This condition is commonly referred to as "shock liver" or "ischemic hepatitis," implying an ischemic cause.
- However, hypotension or shock is not consistently present in these cases.
Purpose of the Study:
- To investigate the causes and characteristics of hepatic enzyme elevation in critically ill patients.
- To determine if hypoxic states, independent of hypotension, contribute to this liver injury.
- To propose a more accurate terminology for this clinical entity.
Main Methods:
- Retrospective analysis of medical records from 293 patients (322 episodes) admitted to critical care units over 13 years.
- Inclusion criteria focused on patients experiencing a hypoxic state.
- Data collection included patient demographics, clinical conditions, and laboratory values.
Main Results:
- Hepatic injury was identified in approximately 1% of critical care admissions.
- Causes of hepatic injury included hypotension, low flow states (e.g., congestive heart failure), and hypoxia from sepsis or respiratory failure.
- Liver enzyme levels typically normalized within days upon correction of the hypoxic etiology, provided no severe co-morbidities intervened.
Conclusions:
- Marked elevation of hepatic enzymes can occur in both hypotensive and normotensive patients experiencing hypoxic states.
- The term "hypoxic hepatopathy" is proposed as a more accurate descriptor for this condition.
- Early identification and management of hypoxic etiologies are crucial for liver enzyme normalization.
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