Increasing Prevalence of Unexplained Liver Necrosis

Brunson, Joel G.; Eckman, Philip L.; Campbell, John B.

doi:10.1056/nejm195707112570202

Cited by 29 publications

(11 citation statements)

References 6 publications

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“…Similarly, the hypoxia/reoxygenation theory could explain the curious observation made by Brunson et al . in the early 1950s . Among 3229 autopsies collected during a 10‐year period, they observed 62 cases of CLN caused by cardiac or circulatory failure.…”

Section: Hemodynamic Pathogenesismentioning

confidence: 99%

Hypoxic hepatitis

Henrion

2011

Liver International

173

143

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Hypoxic hepatitis (HH), an acute liver injury also known as 'ischaemic hepatitis' or 'shock liver', is frequently observed in intensive care units. HH is heralded by a massive but transient rise in serum aminotransferase activities caused by anoxic necrosis of centrilobular liver cells. Cardiac failure, respiratory failure and toxic-septic shock are the main underlying conditions accounting for more than 90% of cases, but HH may also occur in other circumstances. Until recently, liver ischaemia, i.e. a drop in hepatic blood flow, was considered the leading, and even the sole, hemodynamic mechanism responsible for HH, and it was generally held that a shock state was required. In reality, other hemodynamic mechanisms of hypoxia, such as passive congestion of the liver, arterial hypoxaemia and dysoxia, play an important role while a shock state is observed in only 50% of cases. Accordingly, 'ischaemic hepatitis' and 'shock liver' are misnomers. Therapy of HH depends primarily on the nature of the underlying condition. The prognosis is poor, with more than half of patients dying during the hospital stay.

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Section: Hemodynamic Pathogenesismentioning

confidence: 99%

Hypoxic hepatitis

Henrion

2011

Liver International

173

143

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“…Some investigators [2,3] suggest that these agents have a deleterious ef fect, causing necrosis in the liver, kidney and gastrointestinal tract, which may contribute to the irreversible nature of the shock. On the other hand, the restoration of blood pressure per se may be life-saving be cause blood flow to the brain and the heart is dependent upon perfusion pressure.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Dopamine on Cardiogenic and Endotoxin Experimental Shock

Marchetti¹,

Longo²,

Merlo³

et al. 1973

Eur Surg Res

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The present investigation was aimed at evaluating cardiovascular effects of dopamine in narcotized dogs with experimental either cardiogenic or endotoxin shock. Cardiogenic shock was induced in two groups of dogs by injecting 0.2 ml mercury into the circumflex branch of the left coronary artery. Endotoxin shock was obtained by administering Escherichia coli endotoxin i. v. in other two Noradrenaline groups of dogs. One group with cardiogenic shock and onewith endotoxin were treated with dopamine by i. v. infusion. The other two groups of dogs were given noradrenaline. Dopamine infusion raised to the normal aortic pressure, left ventricular systolic pressure, dp/dt, contractility index (dp/dt)/P and cardiac work, previously reduced by shock, and increased considerably aortic, coronary, mesenteric, renal flows, whereas femoral flow showed modest change. Heart rate did not change significantly. Total peripheral resistance increased after shock and showed a tendency to diminish when dopamine was given at the doses of 5 and 10 µg/kg/min. Coronary resistances rose after shock and fell towards normal after dopamine. Mesenteric and renal resistance increased after shock and declined modestly when dopamine was given or did not show significant changes. Noradrenaline after two types of shock improved cardiac performance to the same extent as dopamine, whereas unlike dopamine it increased considerably total peripheral, coronary, mesenteric, renal and femoral resistances.

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“…She received no specific therapy, and her temperature and serum bilirubin returned to normal during a 10-day period. Three days after discharge (Aug. 13,1961) the patient returned to the hospital after rupture of the fetal membranes and was in active labor. Her blood pressure was 120/60 mm.…”

Section: Report Of a Casementioning

confidence: 99%

“…*.18-20 Infarcts of the liver are rare in man3"5 and occur most often after obstruction of the hepatic artery or its branches. 3,1923 Blockage of small intrahepatic branches of the hepatic artery often causes no recognizable damage or may result in Zahn's infarcts (atrophie More recently Brunson et al 13 noted an increasing prevalence of unexplained liver necrosis. They cited evidence implicating sympathomimetic amines in the production of hepatic necrosis in dogs and suggested that the increased use of these agents during the last few years might have accounted for their findings.…”

Section: Commentmentioning

confidence: 99%