‘Liver function tests’ on the intensive care unit: a prospective, observational study

Thomson, Sarah; Cowan, Matthew; Johnston, Ian; Musa, S; Grounds, Michael; Rahman, Tony

doi:10.1007/s00134-009-1511-7

Cited by 69 publications

(74 citation statements)

References 15 publications

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“…Each of these explanations are plausible in our population, and a natural extension of this pilot study will be looking at additional liver panels to see trends in ALT as the Veteran recovers from the injury. If the initial liver panel demonstrates an elevated ALT in the acute period following the TBI, this would favor a spectrum of liver injury associated with critical illness, as suggested by Thompson et al [9]. However, if liver enzyme elevations develop or worsen in the days and weeks that follow, a more likely explanation in this patient population is drug-induced liver injury.…”

Section: Discussionmentioning

confidence: 93%

Elevated liver enzymes following polytraumatic injury

Fox¹,

Sanderlin

McNamee

et al. 2014

J Rehabil Res Dev

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Abstract-This retrospective cohort study examined the prevalence and potential risk factors for elevated liver enzymes in patients following traumatic brain injury (TBI). The participants were servicemembers with TBI admitted to the Polytrauma Rehabilitation Center (PRC) at the Hunter Holmes McGuire Department of Veterans Affairs Medical Center in Richmond, Virginia, from January 2008 through December 2011. The PRC had 207 patients during this time period, 121 of whom had a liver panel within 30 d of injury. Patients were retrospectively analyzed and placed into one of two categories based on alanine aminotransferase (ALT) values. Of the 121 subjects, 59 (49%) had an ALT of 44 IU/L or greater on their initial set of laboratories. These subjects were compared with those with an ALT of 43 IU/L or less using chi square analysis. There were no significant differences between the two groups with regard to sex, military status, race, theater, TBI mechanism, severity of TBI, or concomitant injuries. Regardless of demographics, mechanism of injury, or extent of trauma, elevated liver enzymes were common in patients admitted to the rehabilitation unit following TBI. For the majority of these patients, enzymes returned to normal with conservative management. In most cases, no specific etiology was ever defined. Further analysis will be performed to determine the most efficient way to monitor these patients so that unnecessary tests are avoided and medical expenses are minimized.

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Section: Discussionmentioning

confidence: 93%

Elevated liver enzymes following polytraumatic injury

Fox¹,

Sanderlin

McNamee

et al. 2014

J Rehabil Res Dev

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“…In critically ill patients with multiple organ failure liver dysfunction is often overshadowed or missed. 3 Hepatic injury in ICU can emerge either as a rapid primary episode caused by an acute reduction in perfusion after shock, hemorrhage, resuscitation or low output septic shock or as a late-onset form of hepatic injury emerging secondarily to multiple septic episodes and medical treatment strategies. 4 New onset of liver dysfunction is a frequent finding in critical ill patients and significantly contributes to increased morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Liver function tests as a prognostic indicator in Pediatric Intensive Care Unit (PICU)

Mallikarjuna

Sood

2018

Int J Contemp Pediatr

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Background: Frank liver failure is incompatible with life. Severity of liver disease is reflected in clinical signs or biochemical alterations. Hepatic dysfunction indicates poor outcome in critically ill patients, but no large systematic investigation into its exact incidence and prognostic relevance has been performed in different population groups.Methods: All PICU admissions during the study period were included. Pattern of admission LFT (Liver Function Tests) was reported. Relationship between clinical events and patient outcome with the LFT panel on day 1 and day 3 were reported. Association between final outcome and day 7 LFT was explored.Results: Deranged AST (Aspartate Transaminase), ALT (Alanine Transaminase), Bilirubin, Albumin, PT (Prothrombin time) and INR (International Normalized Ratio) on Day1 and 3 had significant association with increased requirement of inotropic and ventilatory support as well with increased mortality. LFT parameters on day 7 showed significant correlation between normal AST, ALT, bilirubin, PT and INR with improved survival.Conclusions: LFT's should be essential part of biochemical profile and doctors caring for sick patients in peripheral hospitals should consider for early referral of patients to higher centers based on LFT parameters for the advanced care they deserve.

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“…Their prognostic ability may be improved by using BAR rather than bilirubin. Clinicians should be aware of this phenomenon not only in patients with liver disease but also in intensive treatment unit (ITU) patients with sepsis, who frequently have liver test dysfunction [5], and where use of albumin as resuscitation fluid may cause confusion if the BAR is not calculated.…”

mentioning

confidence: 99%

Increased bilirubin following fluid resuscitation with albumin: mechanisms behind an important observation

Hogan

O’Beirne

2011

Intensive Care Med

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‘Liver function tests’ on the intensive care unit: a prospective, observational study

Abstract: Low-grade abnormalities of LFT are a significant entity in critically ill patients and show an association with mortality outcomes and clinical events on ICU. They are likely to represent part of a spectrum of liver injury associated with critical illness and should not be disregarded.

Cited by 69 publications

References 15 publications

Elevated liver enzymes following polytraumatic injury

Elevated liver enzymes following polytraumatic injury

Liver function tests as a prognostic indicator in Pediatric Intensive Care Unit (PICU)

Increased bilirubin following fluid resuscitation with albumin: mechanisms behind an important observation

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