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Liver function in septic shock

J G Banks, A K Foulis, I M Ledingham

    Journal of Clinical Pathology
    |November 1, 1982
    PubMed
    Summary
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    Persistent jaundice in septic shock patients indicates a poor prognosis. Liver histology revealed cholestasis and damage, suggesting a link between septic shock and liver injury.

    Area of Science:

    • Hepatology
    • Critical Care Medicine
    • Pathology

    Background:

    • Septic shock is a severe condition with high mortality.
    • Liver dysfunction is a common complication in critically ill patients.
    • The specific mechanisms of liver injury in septic shock require further elucidation.

    Purpose of the Study:

    • To investigate liver function test abnormalities in septic shock patients.
    • To correlate liver function test results with patient prognosis.
    • To examine liver histology for pathological changes associated with septic shock.

    Main Methods:

    • Serum liver function tests were analyzed in 57 Intensive Therapy Unit (ITU) patients with septic shock.
    • Patient prognosis was assessed in relation to biochemical disturbances.

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  • Post-mortem liver histology was performed on 22 patients.

    • Main Results:

    • Persisting hyperbilirubinaemia was significantly associated with a poor prognosis.
    • Liver histology in 16 out of 22 patients showed non-specific reactive changes, congestion, necrosis, fatty change, and intrahepatic cholestasis.
    • Six patients exhibited severe cholestasis with inspissated bile in cholangioles.

    Conclusions:

    • Elevated bilirubin levels in septic shock are a marker of poor outcome.
    • Septic shock can lead to significant intrahepatic cholestasis and liver damage.
    • The etiology of cholestasis in septic shock warrants further investigation.