Related Experiment Video
Updated: Mar 15, 2026
09:44
Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen
Published on: November 27, 2019
11.2K
Hepatic dysfunction: A common occurrence in severely injured patients
A Saloojee1, D L Skinner2, E Loots3
1Department of Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa.
Injury
|September 8, 2016
Summary
Hepatic dysfunction is common in critically ill trauma patients, associated with longer hospital stays and higher mortality. Early identification of risk factors is crucial for improving patient outcomes in intensive care units.
Area of Science:
- Critical Care Medicine
- Hepatology
- Trauma Surgery
Background:
- Hepatic dysfunction (HD) is frequently observed in critically ill patients, stemming from cholestasis or hypoxic liver injury.
- Serum bilirubin levels are key indicators for assessing liver function in intensive care settings.
Purpose of the Study:
- To determine the incidence of HD in critically ill trauma patients.
- To identify risk factors associated with HD.
- To analyze the impact of HD on patient outcomes, including mortality and length of stay.
Main Methods:
- A retrospective observational study involving 225 patients admitted to a Level 1 Trauma Unit ICU.
- HD was defined as a total bilirubin level exceeding 34.2 μmol/l (2 mg/dL).
- Demographic, physiological, biochemical, and pharmaceutical data were collected to identify risk factors.
Main Results:
- The incidence of HD was 21.3% (48 patients).
- HD was significantly associated with increased duration of ventilation, prolonged ICU length of stay, and higher mortality rates.
- Shock on admission was more prevalent in patients with HD, and piperacillin-tazobactam and enalapril were linked to HD.
Conclusions:
- Hepatic dysfunction is a common complication in critically ill trauma patients.
- HD correlates with other organ dysfunction, increased mortality, and extended hospital stays.
- While HD was associated with adverse outcomes in univariate analysis, it was not independently linked to mortality in multivariable analysis.
More Related Videos
Related Concept Videos
01:26Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
312
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
312
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
248
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
248
01:08Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment
324
Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
324
01:14Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug
277
In pharmacotherapy, monitoring drug concentrations is paramount, especially for drugs whose therapeutic effects hinge on both the active compound and its metabolite. Hepatic impairment profoundly influences drug potency by altering liver function. If the drug is more potent than its metabolite, impaired liver function amplifies drug activity due to elevated drug concentration levels. Conversely, if the metabolite holds greater potency, diminished liver function diminishes drug activity by...
277
01:28Esophageal Varices-II: Clinical Features and Management
727
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...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
727
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
452
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
452