[Ischaemic cholestasis in intensive care unit].
M Beaussier1, E Schiffer, C Housset
1Département d'anesthésie-réanimation chirurgicale, hôpital Saint-Antoine, AP-HP, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France. marc.beaussier@sat.aphp.fr
Annales Francaises D'Anesthesie Et De Reanimation
|September 2, 2008
Summary
Ischaemic cholestasis in the ICU, often caused by hepatic artery issues, leads to poor outcomes. This condition involves bile duct proliferation and can cause liver fibrosis, potentially due to impaired hepatocyte transporters.
Area of Science:
- Hepatology and critical care medicine
Context:
- Cholestasis is a common complication in intensive care units (ICUs), frequently linked to adverse patient outcomes.
- Ischaemia is a significant, yet often overlooked, etiological factor contributing to cholestasis in the ICU setting.
Purpose:
- To highlight the role of ischaemia in inducing cholestasis within the ICU.
- To elucidate the pathological mechanisms and clinical implications of ischaemic cholestasis.
Summary:
- Ischaemia, particularly hepatic artery interruption, triggers cholestasis in ICUs, characterized by biliary proliferation and potential liver fibrosis.
- Resolution of cholestasis occurs spontaneously over weeks, though underlying hypoxia may disrupt hepatocyte bile salt transporters.
Impact:
- Understanding ischaemic cholestasis aids in managing ICU patients with liver dysfunction.
- This research may inform targeted therapies for cholestasis by addressing its ischaemic origins and transporter dysregulation.
Related Concept Videos
01:20Cholecystitis
Cholecystitis is inflammation of the gallbladder, most commonly caused by obstruction of the cystic duct. This blockage prevents bile from draining, leading to gallbladder distension, inflammation, and potentially serious complications. This condition may present acutely or chronically and can happen with or without gallstones.EtiologyAbout 95% of cholecystitis cases are calculous, caused by gallstones blocking the cystic duct, leading to bile accumulation and inflammation of the gallbladder...
01:17Chronic Bowel Disorders: Introduction
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:29Chronic Pancreatitis II: Collaborative Care
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
01:28Esophageal Varices-II: Clinical Features and Management
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
01:30Acute Pancreatitis II: Clinical Manifestations and Management
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
01:25Acute Pancreatitis I: Introduction
Acute pancreatitis is the sudden inflammation of the pancreas caused by the early activation of digestive enzymes, leading to the autodigestion of pancreatic tissue. This results in local inflammation and, in severe cases, systemic complications.EtiologyUnderstanding the underlying causes is crucial, as identifying the etiology guides treatment and anticipates complications. Acute pancreatitis can be triggered by various factors, typically grouped into the following clinical categories.Biliary...