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Related Concept Videos

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

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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...
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Acute Pancreatitis II: Clinical Manifestations and Management01:30

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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...
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The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
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Hepatic Drug Excretion: Influencing Factors01:16

Hepatic Drug Excretion: Influencing Factors

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The biliary system of the liver, crucial for bile secretion and drug excretion, comprises intrahepatic bile ducts that merge to form the common hepatic duct. This duct, carrying hepatic bile, combines with the cystic duct, draining the gallbladder and forming the common bile duct, which empties into the duodenum. Bile, produced by hepatic cells lining the bile canaliculi, is composed primarily of water, bile salts, pigments, electrolytes, and lesser amounts of cholesterol and fatty acids. Bile...
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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...
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Related Experiment Video

Updated: Mar 3, 2026

Bile Duct Ligation in Mice: Induction of Inflammatory Liver Injury and Fibrosis by Obstructive Cholestasis
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Circulating bile acids predict outcome in critically ill patients.

Thomas Horvatits1,2, Andreas Drolz1,2, Karoline Rutter1,2

  • 1Division of Gastroenterology and Hepatology, Department Internal Medicine 3, Medical University of Vienna, Vienna, Austria.

Annals of Intensive Care
|May 4, 2017
PubMed
Summary

Elevated circulating bile acids (BAs) in critically ill patients, especially those with septic shock, predict mortality. These BAs correlate with illness severity, inflammation, and kidney dysfunction, offering early risk stratification potential.

Keywords:
Bile acidsCardiogenic shockCholestasisCritically ill patientsICUSeptic shock

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Using Multi-fluorinated Bile Acids and In Vivo Magnetic Resonance Imaging to Measure Bile Acid Transport
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Area of Science:

  • Critical care medicine
  • Hepatology
  • Biochemistry

Background:

  • Jaundice and cholestatic liver dysfunction are common in critically ill patients, linked to higher mortality.
  • Cholestasis in critical illness involves pro-inflammatory cytokines, impairing bile secretion and causing bile acid accumulation.
  • The clinical significance of circulating bile acids in critically ill patients requires further evaluation.

Purpose of the Study:

  • To investigate the clinical role and prognostic value of circulating bile acids in critically ill patients.

Main Methods:

  • Serum total and individual bile acids were quantified using high-performance liquid chromatography.
  • The study included 320 critically ill patients and 19 healthy controls.

Main Results:

  • Total serum bile acids were significantly higher in septic shock patients compared to cardiogenic shock, post-surgical patients, and controls.
  • Elevated bile acid levels correlated with illness severity, renal dysfunction, and inflammation.
  • Total bile acids independently predicted 28-day mortality, particularly in septic shock patients.

Conclusions:

  • Bile acids are elevated in various shock conditions in critically ill patients.
  • Bile acids serve as an early predictor of short-term survival and aid in risk stratification.
  • Further research is needed to explore the impact of modulating bile acid metabolism on clinical outcomes.