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Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis
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Prediction of Early Liver Failure in Pediatric Patients Admitted to Intensive Care Unit

Mozhgan Zahmatkeshan1, Zahra Serati2, Shole Freydooni2

  • 1Gastrenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Middle East Journal of Digestive Diseases
|November 6, 2019
PubMed

Insights

Early liver dysfunction in critically ill children, indicated by elevated liver enzymes and INR, can predict mortality and longer PICU stays. Abnormal aminotransferases (ALT, AST) and INR are key indicators.

Area of Science:

  • Pediatrics
  • Critical Care Medicine
  • Hepatology

Background:

  • Hepatic dysfunction is linked to poor outcomes in critically ill patients.
  • Early identification of liver dysfunction is crucial for prognosis.

Purpose of the Study:

  • To determine the incidence of early liver dysfunction in Iranian pediatric intensive care unit (PICU) patients.
  • To identify variables predictive of mortality and prolonged PICU stay.

Main Methods:

  • A cohort of 149 pediatric patients in the PICU were studied.
  • Serum liver function tests (aminotransferase, alkaline phosphatase, bilirubin, INR) were measured at 24, 48, and 96 hours post-admission.
  • Logistic regression analysis was used to assess associations with mortality and PICU length of stay.

Main Results:

  • Abnormal alkaline phosphatase was most common (66.9%) on day one; abnormal direct bilirubin was least common (9.1%).
  • Elevated ALT, AST, INR, total bilirubin, and direct bilirubin predicted increased mortality in univariable analysis.
  • In multivariable analysis, only ALT and INR at 24 hours significantly predicted mortality.

Conclusions:

  • Increased liver enzymes and INR in critically ill children may serve as early predictors of mortality.
  • These liver function markers can also indicate an increased PICU length of stay.

Keywords:
Hepatic dysfunctionIntensive care unitsIranMortalityPediatric

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