Liver Dysfunction in Critically Ill Patients

Abstract

Patients with acute hepatobiliary dysfunction are frequently encountered in the intensive care unit. Therefore, it is important for intensivists to understand the various causes of hepatobiliary dysfunction and to have a thorough understanding of the pathophysiology, presentation, and management in each process. The aim of this chapter is to discuss the most common causes of acute hepatobiliary dysfunction encountered in the intensive care unit. List of Abbreviations AAC Acute acalculous cholecystitis ALP Alkaline phosphatase ALT Alanine aminotransferase AST Aspartate aminotransferase BSEP Bile salt export pump CHF Congestive heart failure CO Cardiac output CT Computed tomography CVP Central venous pressure DILI Drug-induced liver injury HH Hypoxic hepatitis HIDA Hepatobiliary iminodiacetic acid ICU Intensive care unit IL Interleukin INR International normalized ratio LDH Lactate dehydrogenase LPS Lipopolysaccharide MRP Multidrug-resistance-associated protein NO Nitric oxide NTCP Sodium-dependent taurocholate cotransporter OATPs Organic anion transport proteins PMH Polymorphonuclear cell PO2 Partial pressure of oxygen ROS Reactive oxygen species SAT Serum aminotransferase SIRS Systemic inflammatory response syndrome *