[Hepatotoxicity in the critically ill patient. The liver under an acute severe insult].
The liver plays an essential role in the metabolism of most of the nutrients since it is a mainly metabolic organ carrying out a series of physiological and metabolic processes related with protein and energy metabolism. The intestinal tract is considered a key element in the development of Multiorgan Dysfunction (MOD) or failure by loosing its barrier function (impaired permeability) against toxins, bio-products and occasionally intraluminal bacteria secondary to hypoxia, one of the main pathophysiogenic mechanisms being the insufficient blood flow to splacnic organs. Liver dysfunction and/or impairment of liver function test are a common event in critically ill patients. They may be due to previous liver cirrhosis or to more immediate causes of liver failure such as sepsis, drugs, liver transplant or any of the multiple etiologies for hepatitis.
García de Lorenzo y Mateos
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Servicio de Medicina Intensiva, Hospital Universitario La Paz, Madrid, Spain. agdl@telefonica.net
Rodríguez Montes
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JA
D016638:Critical Illness; D004734:Energy Metabolism; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000502:physiology*; D008102:Liver Circulation; D017093:Liver Failure / Q000209:etiology* / Q000628:therapy; D008111:Liver Function Tests; D009102:Multiple Organ Failure / Q000209:etiology* / Q000503:physiopathology; D018529:Nutritional Support; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology