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Related Experiment Video

Updated: Mar 13, 2026

Visualization and Analysis of Blood Flow and Oxygen Consumption in Hepatic Microcirculation: Application to an Acute Hepatitis Model
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Hypoxic Hepatitis: A Review and Clinical Update.

Najeff Waseem1, Po-Hung Chen2

  • 1Division of Gastroenterology & Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; George Washington School of Medicine and Health Sciences, Washington, DC, USA.

Journal of Clinical and Translational Hepatology
|October 26, 2016
PubMed
Summary

Hypoxic hepatitis (HH), or shock liver, causes rapid aminotransferase increases due to low oxygen delivery. Treatment focuses on underlying causes, as HH has a poor prognosis with over 50% in-hospital mortality.

Keywords:
HepatitisHypoxiaIschemiaLiver injury

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Area of Science:

  • Hepatology
  • Critical Care Medicine

Background:

  • Hypoxic hepatitis (HH), also known as ischemic hepatitis or shock liver, is a condition marked by a rapid, significant rise in serum aminotransferases.
  • It stems from insufficient oxygen delivery to the liver, often linked to cardiac failure, septic shock, or respiratory failure.

Approach:

  • Diagnosis is primarily clinical, relying on patient presentation and laboratory findings, often without requiring a liver biopsy.
  • Pathophysiology is multifactorial, involving hepatic congestion, reduced hepatic blood flow, systemic hypoxemia, and potential reperfusion injury.

Key Points:

  • HH occurs in 50% of patients without a documented hypotensive event.
  • Incidence in ICUs is approximately 2.5%, potentially reaching 10% in some studies.
  • Management involves addressing the underlying condition and monitoring for complications like hypoglycemia, hyperglycemia, hyperammonemia, and hepatopulmonary syndrome.

Conclusions:

  • The prognosis for HH is poor, with in-hospital mortality exceeding 50%.
  • Delayed diagnosis is associated with a worse outcome.
  • Death is typically attributed to the predisposing condition rather than the liver injury itself.