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Secondary hepatic dysfunction in pediatric intensive care unit: Risk factors and outcome

Engy A Mogahed1, Haytham Ghita1, Mona S El-Raziky1

  • 1Department of Pediatrics, Kasr Alainy Medical School, Cairo University, Cairo, Egypt.

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|June 13, 2020
PubMed

Insights

Secondary hepatic dysfunction is common in pediatric intensive care units. Sepsis, cardiovascular events, and hypoxia are key risk factors, leading to increased mortality and longer hospital stays.

Area of Science:

  • Pediatric critical care medicine
  • Hepatology
  • Intensive care research

Background:

  • Hepatic dysfunction significantly impacts morbidity and mortality in intensive care unit (ICU) patients.
  • Secondary hepatic dysfunction is a critical concern in pediatric critical care settings.

Purpose of the Study:

  • To determine the frequency, risk factors, and outcomes of secondary hepatic dysfunction in children admitted to the pediatric ICU.
  • To identify key predictors and consequences of acquired liver dysfunction in critically ill children.

Main Methods:

  • A prospective study involving 151 pediatric ICU patients.
  • Defined secondary hepatic dysfunction as new-onset abnormal liver function during ICU stay in patients without prior liver disease.
  • Collected data on patient demographics, clinical conditions (sepsis, shock, hypoxia), treatments (inotropes, ventilation, antibiotics), and mortality scores. Liver function tests were monitored regularly.

Main Results:

  • Secondary hepatic dysfunction developed in 43 (28.5%) of the patients.
  • Significant risk factors included sepsis, cardiovascular events, hypoxia, mechanical ventilation, inotropic support, and antibiotic use.
  • This dysfunction was strongly associated with increased mortality and prolonged ICU length of stay.

Conclusions:

  • Secondary hepatic dysfunction is a frequent complication in pediatric ICUs.
  • Sepsis, cardiovascular events, and hypoxia are primary risk factors.
  • The presence of secondary hepatic dysfunction is a significant predictor of poor outcomes, including mortality and extended hospitalization.
Abstract

Keywords:
ChildrenCritically ill patientsLength of stayMortality

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