Les anesthésiques volatiles et l’atteinte hépatique: une mise à jour clinique ou ce que tout anesthésiologiste devrait savoir

Martin, Jackie L.

doi:10.1007/bf03027715

Cited by 35 publications

(36 citation statements)

References 18 publications

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“…2,5 This patient developed fever, jaundice, encephalopathy, and marked elevations in ALT and AST, and she finally died on the third postoperative day. Sevoflurane hepatitis as a cause for liver failure cannot be excluded in this complex situation of cardiac surgery using extracorporeal circulation.…”

Section: Discussionmentioning

confidence: 99%

“…Several risk factors for volatile anestheticinduced hepatitis have been described. 2,5 Re-exposure is the major risk factor, more than 90% of the patients affected will have a history of such previous exposure. Further risk factors include middle-aged patients with a peak incidence between 50 and 60 yr, obesity, female gender, history of drug atopy or multiple drug allergies, and induction of the cytochrome P-450 system by drugs or chronic ingestion of ethanol.…”

Section: Discussionmentioning

confidence: 99%

“…Further risk factors include middle-aged patients with a peak incidence between 50 and 60 yr, obesity, female gender, history of drug atopy or multiple drug allergies, and induction of the cytochrome P-450 system by drugs or chronic ingestion of ethanol. 2,5 The etiology of severe halothane-induced hepatitis is thought to be immunologically mediated. 2,5,6 Halothane is metabolized by the cytochrome P-450 system resulting in the formation of several reactive intermediates, principally trifluoroacetyl chloride, 1,8 which is able to bind to amino groups of proteins.…”

Section: Discussionmentioning

confidence: 99%

“…Theoretically, patients sensitized to the other volatile anesthetics could be safely anesthetized with sevoflurane. 2 However, we report a case of lethal hepatic failure in a woman undergoing cardiac surgery with a sevoflurane, sufentanil and propofol anesthesia. Consent for publication of this report received approval from the Institutional Review Board according to German legal practice (Landeskrankenhausgesetz Rheinland-Pfalz).…”

mentioning

confidence: 94%

“…1,2 All patients anesthetized with these agents have the potential to form these altered liver proteins that can act as haptens. At re-exposure to any of these halogenated volatile anesthetics, an immune-mediated toxicity may rarely cause volatile anesthetic-induced hepatitis, leading to hepatic injury which may occasionally be fatal.…”

mentioning

confidence: 99%

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Case report: Fatal hepatic failure after aortic valve replacement and sevoflurane exposure

Lehmann

Neher

Kiessling

et al. 2007

Can J Anesth/J Can Anesth

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Purpose: To report a case of lethal hepatotoxicity possibly caused by sevoflurane. Clinical features:A 76-yr-old woman with a history of four previous minor surgical procedures developed acute liver failure after general anesthesia with sevoflurane, sufentanil and propofol for aortic valve replacement. After an uneventful procedure the patient was extubated 4.5 hr after surgery. On the second postoperative day, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increased. On the third postoperative day liver failure occurred, ALT peaked at 10504 U·L -1 and AST at 15516 U·L -1 , and coagulopathy with an international normalized ratio of 4.6 developed. Liver transplantation was considered but rejected as a therapeutic option. The patient died three days after the operation in multiple organ failure triggered by hepatic failure. Other possible causes for liver failure were excluded. Conclusions:Sevoflurane hepatitis as a cause for liver failure may be implicated in this patient undergoing valve surgery. Unlike other halogenated anesthetic drugs, sevoflurane is not metabolized to hepatotoxic trifluroacetyl proteins. However, compound A may react with proteins and may be transformed into antigenic material. We suggest that all halogenated anesthetics may be implicated with acute liver injury.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 94%

mentioning

confidence: 99%

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Case report: Fatal hepatic failure after aortic valve replacement and sevoflurane exposure

Lehmann

Neher

Kiessling

et al. 2007

Can J Anesth/J Can Anesth

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Cohort Multicenter Study on the Role of Medications in Parenteral Nutrition–Related Alteration of Liver Function Tests in Adults

Antonio

Miana‐Mena

Martínez‐Bernabé³

et al. 2020

J Parenter Enteral Nutr

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Background Our objective was to assess in non–critically‐ill adult inpatients receiving parenteral nutrition (PN) the risk of developing liver function test (LFT) alterations when receiving concomitant possibly hepatotoxic medications or others reported to improve LFTs during PN. Methods A multicenter retrospective analysis of prospectively collected data was performed on patients receiving PN. Two groups were recruited: group LALT (patients with any LFT alterations during PN), and group NOLALT (patients without such alterations). Exclusion criteria were previous sepsis, shock, renal failure, hyperglycemia, LFT alteration, or biliopancreatic surgical procedures. Medications were classified into 2 categories: medications reported to improve LFTs during PN (n = 8) and possibly hepatotoxic medications (n = 54), including a subgroup of possibly highly hepatotoxic medications (n = 30). Results The study included 200 patients, 136 (68.0%) in the LALT group. The groups differed in the number of patients requiring surgical intervention ≤7 days before PN (LALT, 94 [69.1%]; NOLALT, 29 [45.3%]; P < .002) and those receiving possibly hepatotoxic medications (LALT, 126 [92.6%]; NOLALT, 45 [70.3%]; P < .001). Variables in the final Cox regression model were possibly hepatotoxic medications, odds ratio (OR) 3.310 (1.678–6.530); surgical intervention prior to PN, OR 1.861 (1.277–2.711); baseline triglyceridemia, OR 1.005 (1.001–1.009); and creatinine, OR 1.861 (1.043–3.323). Conclusions Patients who received PN and concomitantly possibly hepatotoxic medications had a 3‐fold risk of developing LFT alterations. Medications reported to improve LFTs had no effect. The use of possibly hepatotoxic medications during PN was associated with LFT alterations.

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Liver Disease in Renal Transplant Recipients

Carrion

Fabrizi

Martin

2014

Kidney Transplantation

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Les anesthésiques volatiles et l’atteinte hépatique: une mise à jour clinique ou ce que tout anesthésiologiste devrait savoir

Cited by 35 publications

References 18 publications

Case report: Fatal hepatic failure after aortic valve replacement and sevoflurane exposure

Case report: Fatal hepatic failure after aortic valve replacement and sevoflurane exposure

Cohort Multicenter Study on the Role of Medications in Parenteral Nutrition–Related Alteration of Liver Function Tests in Adults

Liver Disease in Renal Transplant Recipients

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