Division of Gastroenterology and Hepatology, Department of Internal Medicine 3, Medical University Vienna, Vienna, Austria.
Curr Opin Crit Care. 2013 Apr;19(2):128-32. doi: 10.1097/MCC.0b013e32835ec9e6.
Liver dysfunction frequently complicates the clinical picture of critical illness and leads to increased morbidity and mortality. The purpose of this review is to characterize the most frequent patterns of liver dysfunction at the intensive care unit, cholestasis and hypoxic liver injury (HLI), and to illustrate its clinical impact on outcome in critically ill patients.
Liver dysfunction at the intensive care unit can be divided into two main patterns: cholestatic and HLI, also known as ischemic hepatitis or shock liver. Both hepatic dysfunctions occur frequently and early in critical illness. Major issues are the early recognition and subsequent initiation of therapeutic measures.
Clinical awareness of the liver not only as a victim, but also as a trigger of multiorgan failure is of central clinical importance. Physicians have to identify the underlying factors that contribute to its development to initiate curative measures as early as possible.
肝功能障碍常使危重病患者的临床表现复杂化，并导致发病率和死亡率增加。本文旨在描述重症监护病房（ICU）中最常见的肝功能障碍类型（胆汁淤积和缺氧性肝损伤[HLI]），并说明其对危重症患者预后的临床影响。
ICU 中的肝功能障碍可分为两种主要类型：胆汁淤积和 HLI，也称为缺血性肝炎或休克肝。这两种肝功能障碍在危重病中都经常且早期发生。主要问题是早期识别和随后开始治疗措施。
临床医生不仅要认识到肝脏是多器官衰竭的受害者，而且是其触发因素，这具有重要的临床意义。医生必须识别导致肝功能障碍发展的潜在因素，以便尽早开始治疗措施。
