The Liver in Critical Illness

Crit Care Clin. 2016 Jul;32(3):425-38. doi: 10.1016/j.ccc.2016.02.002.

Abstract

Caring for critically ill patients with acute and/or chronic liver dysfunction poses a unique challenge. Proper resuscitation and early consideration for transfer to liver transplant centers have resulted in improved outcomes. Liver support devices and cellular models have not yet shown mortality benefit, but they hold promise in the critical care of patients with liver disease. This article reviews pertinent anatomic and physiologic considerations of the liver in critical illness, followed by a selective review of associated organ dysfunction.

Keywords: Acute liver failure (ALF); Acute respiratory distress syndrome (ARDS); Acute-on-chronic liver failure (ACLF); Critical illness; Intracranial hypertension (IH); Multiple organ failure (MOF).

Publication types

  • Review

MeSH terms

  • Blood Coagulation Disorders / etiology
  • Blood Coagulation Disorders / therapy
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / therapy
  • Critical Care*
  • Critical Illness* / therapy
  • Hepatic Encephalopathy / etiology
  • Hepatic Encephalopathy / therapy*
  • Hepatorenal Syndrome / therapy
  • Humans
  • Infections / diagnosis
  • Infections / drug therapy
  • Liver Diseases / complications*
  • Liver Diseases / etiology
  • Liver Diseases / physiopathology*
  • Protein-Energy Malnutrition / etiology
  • Protein-Energy Malnutrition / therapy
  • Respiratory Tract Diseases / etiology
  • Respiratory Tract Diseases / therapy
  • Severity of Illness Index