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hypoxic hepatitis

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Najeff Waseem, Po-Hung Chen
Hypoxic hepatitis (HH), also known as ischemic hepatitis or shock liver, is characterized by a massive, rapid rise in serum aminotransferases resulting from reduced oxygen delivery to the liver. The most common predisposing condition is cardiac failure, followed by circulatory failure as occurs in septic shock and respiratory failure. HH does, however, occur in the absence of a documented hypotensive event or shock state in 50% of patients. In intensive care units, the incidence of HH is near 2.5%, but has been reported as high as 10% in some studies...
September 28, 2016: Journal of Clinical and Translational Hepatology
B Champigneulle, G Geri, W Bougouin, F Dumas, M Arnaout, L Zafrani, F Pène, J Charpentier, J P Mira, A Cariou
AIM: Hypoxic hepatitis (HH) may complicate the course of resuscitated out-of-hospital cardiac arrest (OHCA) patients admitted in intensive care unit (ICU). Aims of this study were to assess the prevalence of HH, and to describe the factors associated with HH occurrence and outcome. METHODS: We conducted an observational study over a 6-year period (2009-2014) in a cardiac arrest center. All non-traumatic OHCA patients admitted in the ICU after return of spontaneous circulation (ROSC) and who survived more than 24h were included...
June 2016: Resuscitation
Rebecca D Powell, Jacob H Swet, Kenneth L Kennedy, Toan T Huynh, Iain H McKillop, Susan L Evans
BACKGROUND: Oxidative stress following hemorrhagic shock and resuscitation (HSR) is regulated, in part, by inflammatory and apoptotic mediators such as necrosis factor κB (NF-κB) and p53. Sirtuin 1 (Sirt-1) is a metabolic intermediary that regulates stress responses by suppressing NF-κB and p53 activity. Resveratrol is a naturally occurring polyphenolic antioxidant and Sirt-1 agonist. The aim of this study was to determine whether resveratrol protects hepatocytes following HSR or hypoxia...
February 2014: Journal of Trauma and Acute Care Surgery
Bernhard Jäger, Andreas Drolz, Barbara Michl, Peter Schellongowski, Andja Bojic, Miriam Nikfardjam, Christian Zauner, Gottfried Heinz, Michael Trauner, Valentin Fuhrmann
UNLABELLED: Hypoxic hepatitis (HH) is the most frequent cause of acute liver injury in critically ill patients. No clinical data exist about new onset of jaundice in patients with HH. This study aimed to evaluate the incidence and clinical effect of jaundice in critically ill patients with HH. Two hundred and six consecutive patients with HH were screened for the development of jaundice during the course of HH. Individuals with preexisting jaundice or liver cirrhosis at the time of admission (n = 31) were excluded from analysis...
December 2012: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Ausra Kavoliuniene, Audrone Vaitiekiene, Giedre Cesnaite
In the setting of long-standing severe chronic heart failure, other organ systems are also involved. The liver is one of the organs that are very sensitive to haemodynamic changes. Differential diagnosis of the liver injury is extremely important in the cardiologist's clinical practice and calls for cardiologist's and hepatologist's collaboration because there are many other diseases that can affect the liver and mimic haemodynamic injury. In this article, liver injuries depending on cardiocirculatory dysfunction such as hypoxic hepatitis and congestive hepatopathy are analysed...
July 1, 2013: International Journal of Cardiology
Jean Henrion
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...
August 2012: Liver International: Official Journal of the International Association for the Study of the Liver
Valentin Fuhrmann, Nikolaus Kneidinger, Harald Herkner, Gottfried Heinz, Mariam Nikfardjam, Anja Bojic, Peter Schellongowski, Bernhard Angermayr, Maximilian Schöniger-Hekele, Christian Madl, Peter Schenk
PURPOSE: Hypoxic hepatitis (HH) is a form of hepatic injury following arterial hypoxemia, ischemia, and passive congestion of the liver. We investigated the incidence and the prognostic implications of HH in the medical intensive care unit (ICU). METHODS: A total of 1,066 consecutive ICU admissions at three medical ICUs of a university hospital were included in this prospective cohort study. All patients were screened prospectively for the presence of HH according to established criteria...
August 2011: Intensive Care Medicine
Joan M Raurich, Juan Antonio Llompart-Pou, Mireia Ferreruela, Asunción Colomar, Maria Molina, Cristina Royo, Ignacio Ayestarán, Jordi Ibáñez
PURPOSE: Hypoxic hepatitis may be induced by hemodynamic instability or arterial hypoxemia in critically ill patients. We investigated the incidence, etiology, association with systemic ischemic injury and risk factors for mortality in this population. METHODS: Retrospective analysis of patients with hypoxic hepatitis admitted to a multidisciplinary intensive care unit (ICU) of a university hospital. Hypoxic hepatitis was defined as the existence of a compatible clinical setting (cardiocirculatory failure or arterial hypoxemia) and aminotransferase levels higher than 1000 IU/L...
February 2011: Journal of Anesthesia
Santo Caroleo, Antonino S Rubino, Francesco Tropea, Orlando Bruno, Domenico Vuoto, Bruno Amantea, Attilio Renzulli
Hypoxic hepatitis (HH) is a severe complication of postoperative low output syndrome, associated with high mortality rates despite appropriate drug therapy. Recently several extracorporeal supportive techniques have become available. We describe the case of a 70-year-old woman who developed HH secondary to cardiogenic shock after cardiac surgery. CPFA proved to be a valid tool for concomitant hemodynamic support and organ replacement therapy.
October 2010: International Journal of Artificial Organs
Valentin Fuhrmann, Bernhard Jäger, Anna Zubkova, Andreas Drolz
Hypoxic hepatitis (HH), also known as ischemic hepatitis or shock liver, is characterized by centrilobular liver cell necrosis and sharply increasing serum aminotransferase levels in a clinical setting of cardiac, circulatory or respiratory failure. Nowadays it is recognized as the most frequent cause of acute liver injury with a reported prevalence of up to 10% in the intensive care unit. Patients with HH and vasopressor therapy have a significantly increased mortality risk in the medical intensive care unit population...
March 2010: Wiener Klinische Wochenschrift
Valentin Fuhrmann, Nikolaus Kneidinger, Harald Herkner, Gottfried Heinz, Mariam Nikfardjam, Anja Bojic, Peter Schellongowski, Bernhard Angermayr, Reinhard Kitzberger, Joanna Warszawska, Ulrike Holzinger, Peter Schenk, Christian Madl
PURPOSE: Hypoxic hepatitis (HH) is a frequent cause of acute hepatocellular damage at the intensive care unit. Although mortality is reported to be high, risk factors for mortality in this population are unknown. METHODS: One-hundred and seventeen consecutive patients with HH were studied prospectively at three medical intensive care units of a university hospital. RESULTS: The main causes of hypoxic hepatitis were low cardiac output and septic shock, and most patients (74%) had more than one underlying factor...
August 2009: Intensive Care Medicine
Valentin Fuhrmann, Christian Madl, Christian Mueller, Ulrike Holzinger, Reinhard Kitzberger, Georg-Christian Funk, Peter Schenk
BACKGROUND & AIMS: The hepatopulmonary syndrome (HPS) is defined as the triad of liver disease, arterial deoxygenation, and widespread pulmonary vasodilatation. Hypoxic hepatitis, also known as ischemic hepatitis, is the leading cause of acute liver impairment in hospitals. It is unknown whether HPS occurs in hypoxic hepatitis. We assessed the prevalence and clinical consequences of HPS in patients with hypoxic hepatitis. METHODS: Forty-four patients with hypoxic hepatitis were screened prospectively for HPS using established criteria: (1) presence of hepatic disease, (2) increased alveolar-arterial difference for the partial pressure of oxygen greater than the age-related threshold, and (3) intrapulmonary vasodilatation detected via contrast-enhanced echocardiography...
July 2006: Gastroenterology
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