Transplantation proceedings
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Intra-abdominal hypertension (IAH) can affect liver hemodynamics but it is not known if has a significant clinical impact on liver function. The aim of this study was to investigate the relationship between IAH and liver function. A prospective study was performed in 110 adult intensive care unit (ICU) patients. ⋯ A strict association between IAH and liver dysfunction was not found. Most likely, low levels of IAH, although able to reduce liver blood flow, are not per se sufficient to produce a real dysfunction; however, a correlation between the degree of IAH and the degree of hyperbilirubinemia exists. IAH does not seem to be an "on-off" phenomenon, but produces liver alterations for increasing levels of its severity.
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The presence of hepatic dysfunction significantly affects the length of hospital stay and the outcome in critically ill patients. Considering the important partial hepatic functions of metabolism, synthesis, detoxification, and excretion, the worse clinical course of patients suffering from hepatic dysfunction is not surprising. The most often used indicator of hepatic dysfunction is bilirubin. ⋯ Thus, ICG excretion rate in bile reflects the hepatic excretory function and hepatic energy status. Because of these features, ICG has been found to be useful to assess liver function in liver donors and transplant recipients, in patients with chronic liver failure, and as a prognostic factor in critically ill patients. Further trials concerning liver dysfunction have applied the noninvasive bedside assessment of ICG among other clinical variables to monitor the progress and/or the reversal of liver dysfunction.