Liver dysfunction in critical illness.

摘要: Abnormal liver function commonly accompanies critical illness. Ischaemic hepatitis occurs with shock and is characterised by elevated plasma aminotransferase concentrations. 'ICU jaundice' later in illness, especially after trauma sepsis. The major biochemical abnormality conjugated hyperbilirubinaemia. clinical setting suggests that hepatic ischaemia hepatotoxic actions of inflammatory mediators are the aetiological factors. Massive blood transfusion, effects nutritional support drug toxicity may contribute. Both presence degree jaundice associated increased mortality several nonhepatic diseases. It proposed Kupffer cell phagocytic depression dysfunction permits systemic spread endotoxin thus predisposes to multiple organ failure. Immunosuppression, metabolic abnormalities, impaired oxidation myocardial contribute poor prognosis. There no specific treatment, but prompt resuscitation, definitive treatment sepsis meticulous supportive care will likely reduce incidence severity.