Hepatic effects of lung-protective pressure-controlled ventilation and a combination of high-frequency oscillatory ventilation and extracorporeal lung assist in experimental lung injury

Kredel, Markus; Muellenbach, Ralf Michael; Johannes, Amelie; Brederlau, Joerg; Roewer, Norbert; Wunder, Christian

doi:10.12659/msm.881974

Cited by 6 publications

(11 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(108) Similar hemodynamic alterations in the liver may occur in mechanically ventilated patients in response to high positive end-respiratory pressure (PEEP). (109,110) Whether these hemodynamic alterations can alter LFTs is unclear. (110) Importantly, the use of high PEEP is usually unnecessary for the respiratory management of patients with COVID-19, as lung compliance is relatively high.…”

Section: Causes Of Lft Elevations In Critically Ill Patientsmentioning

confidence: 99%

See 1 more Smart Citation

Abnormal Liver Function Tests in Patients With COVID‐19: Relevance and Potential Pathogenesis

et al. 2020

View full text Add to dashboard Cite

AST and ALT elevations had also been reported in patients with SARS caused by SARS-CoV. (37) Several case reports have described severe LFT abnormalities (18,38,39) or acute-on-chronic (40,41) liver failure in patients with COVID-19. Zhang et al. (33) reported that 1 of 82 deceased patients with COVID-19 had a hepatic cause of death, although it was not clear whether this patient had pre-existing liver disease.Elevated ALP was reported in 2%-5% of patients, (5,11,25,42) and elevated GGT was reported in 13%-54% of patients (weighted average: 23%). (5,11,19,42) The prevalence of total bilirubin elevations ranged between 1% and 18% of patients with COVID-19 on admission. (4,5,15,16,18,25,35,43) It should be realized, aRtICle INFoRMatIoN:

show abstract

Section: Causes Of Lft Elevations In Critically Ill Patientsmentioning

confidence: 99%

“…(109,110) Whether these hemodynamic alterations can alter LFTs is unclear. (110) Importantly, the use of high PEEP is usually unnecessary for the respiratory management of patients with COVID-19, as lung compliance is relatively high. (111)…”

Section: Causes Of Lft Elevations In Critically Ill Patientsmentioning

confidence: 99%

Abnormal Liver Function Tests in Patients With COVID‐19: Relevance and Potential Pathogenesis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…59 In mechanically ventilated patients (where high positive end-respiratory pressure is used), similar hemodynamic alterations have been described, mainly due to increased intra-abdominal pressure. 60,61 Studies in this context show abnormal liver enzymes, but their meaning is unclear. 61 The hepatic ischemia and hypoxia-reperfusion dysfunction lead to lipid accumulation in hepatocytes until cell death.…”

Section: Hypoxia-reperfusion Injurymentioning

confidence: 99%

“…60,61 Studies in this context show abnormal liver enzymes, but their meaning is unclear. 61 The hepatic ischemia and hypoxia-reperfusion dysfunction lead to lipid accumulation in hepatocytes until cell death. Hypoxia also induces an increase in reactive oxygen species, and their peroxidation products act as a second messenger activating redox-sensitive transcription factors and amplifying the release of multiple proinflammatory cytokines.…”

Section: Hypoxia-reperfusion Injurymentioning

confidence: 99%

COVID-19 and Indirect Liver Injury: A Narrative Synthesis of the Evidence

Idalsoaga¹,

Ayares²,

Arab³

et al. 2021

Journal of Clinical and Translational Hepatology

View full text Add to dashboard Cite

The liver is frequently affected by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection. The most common manifestations are mildly elevated alanine aminotransferase and aspartate aminotransferase, with a prevalence of 16-53% among patients. Cases with severe coronavirus disease 2019 (COVID-19) seem to have higher rates of acute liver dysfunction, and the presence of abnormal liver tests at admission signifies a higher risk of severe disease during hospitalization. Patients with chronic liver diseases also have a higher risk of severe disease and mortality (mainly seen in patients with metabolic-associated fatty liver disease). Several pathways of damage have been proposed in the liver involvement of COVID-19 patients; although, the end-cause is most likely multifactorial. Abnormal liver tests have been attributed to the expression of angiotensin-converting enzyme 2 receptors in SARS-CoV-2 infection. This enzyme is expressed widely in cholangiocytes and less in hepatocytes. Other factors attributed to liver damage include drug-induced liver injury, uncontrolled release of proinflammatory molecules ("cytokine storm"), pneumonia-associated hypoxia, and direct damage by the infection. Hepatic steatosis, vascular thrombosis, fibrosis, and inflammatory features (including Kupffer cell hyperplasia) are the most common liver histopathological findings in deceased COVID-19 patients, suggesting important indirect mechanisms of liver damage. In this translational medicinebased narrative review, we summarize the current data on the possible indirect mechanisms involved in liver damage due to COVID-19, the histopathological findings, and the impact of these mechanisms in patients with chronic liver disease.

show abstract

“…The physiological consequences of mechanical ventilation are related to increased intrathoracic pressure, which inherently affects the heart, 1 central nervous system, 2 kidney, 3 and liver. 4 Furthermore, clinical conditions that lead to high intra-abdominal pressure deserve special attention during respiratory system monitoring, as the abdominal compartment is an integral part of the chest wall. 5 6 7 8 9…”

mentioning

confidence: 99%

Physiological and Pathophysiological Consequences of Mechanical Ventilation

Silva

Ball

Rocco

et al. 2022

Semin Respir Crit Care Med

View full text Add to dashboard Cite

Mechanical ventilation is a life-support system used to ensure blood gas exchange and to assist the respiratory muscles in ventilating the lung during the acute phase of lung disease or following surgery. Positive-pressure mechanical ventilation differs considerably from normal physiologic breathing. This may lead to several negative physiological consequences, both on the lungs and on peripheral organs. First, hemodynamic changes can affect cardiovascular performance, cerebral perfusion pressure (CPP), and drainage of renal veins. Second, the negative effect of mechanical ventilation (compression stress) on the alveolar-capillary membrane and extracellular matrix may cause local and systemic inflammation, promoting lung and peripheral-organ injury. Third, intra-abdominal hypertension may further impair lung and peripheral-organ function during controlled and assisted ventilation. Mechanical ventilation should be optimized and personalized in each patient according to individual clinical needs. Multiple parameters must be adjusted appropriately to minimize ventilator-induced lung injury (VILI), including: inspiratory stress (the respiratory system inspiratory plateau pressure); dynamic strain (the ratio between tidal volume and the end-expiratory lung volume, or inspiratory capacity); static strain (the end-expiratory lung volume determined by positive end-expiratory pressure [PEEP]); driving pressure (the difference between the respiratory system inspiratory plateau pressure and PEEP); and mechanical power (the amount of mechanical energy imparted as a function of respiratory rate). More recently, patient self-inflicted lung injury (P-SILI) has been proposed as a potential mechanism promoting VILI. In the present chapter, we will discuss the physiological and pathophysiological consequences of mechanical ventilation and how to personalize mechanical ventilation parameters.

show abstract

Hepatic effects of lung-protective pressure-controlled ventilation and a combination of high-frequency oscillatory ventilation and extracorporeal lung assist in experimental lung injury

Cited by 6 publications

References 28 publications

Abnormal Liver Function Tests in Patients With COVID‐19: Relevance and Potential Pathogenesis

Abnormal Liver Function Tests in Patients With COVID‐19: Relevance and Potential Pathogenesis

COVID-19 and Indirect Liver Injury: A Narrative Synthesis of the Evidence

Physiological and Pathophysiological Consequences of Mechanical Ventilation

Contact Info

Product

Resources

About