| Hemodynamics and metabolic studies on septic shock in patients with acute liver failure. | |
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MedLine Citation:
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PMID: 19056008 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Acute liver failure is often accompanied by hyperdynamic circulation, which is also a characteristic of septic shock. Pre-existing acute liver failure may worsen the hemodynamic impairment and prognosis in sepsis. AIMS: To evaluate the hemodynamic and metabolic characteristics and clinical outcomes of septic shock in patients with acute liver failure. METHODS: Twenty patients with acute liver failure and 19 patients without preexisting liver disease were evaluated. Systemic hemodynamics, arterial and mixed vein blood gases, arterial lactate levels, plasma renin activity, and plasma aldosterone levels were checked during the early phase of septic shock. RESULTS: In acute liver failure group, cardiac index (4.92 +/- 1.13 vs 3.69 +/- 1.06 L/min per square meter, P < .001) and oxygen delivery (604.7 +/- 139.7 vs 485.4 +/- 137.3 mL/min per square meter, P = .011) were significantly higher than those without preexisting liver diseases, while systemic vascular resistance index (1041.2 +/- 503.3 vs 1409 +/- 505.25 dyne.s/cm(5).m(2)), oxygen consumption (119.1 +/- 29.2 vs 162.4 +/- 49.4 mL/min per square meter) and oxygen extraction ratio (20% +/- 6% vs. 32% +/- 8%) were significantly higher in the latter group. Furthermore, the patients with acute liver failure had higher arterial lactate (P = .026), plasma renin activity (P = .03), plasma aldosterone levels (P < .001), and intensive care unit as well as hospital mortality rates (P = .005, and 0.02 respectively). CONCLUSIONS: In patients with acute liver failure, septic shock was characterized by an accentuated hyperdynamic circulation, hyperlactatemia and an augmented renin-angiotensin-aldosterone system activity. Pre-existing liver failure has a significant impact on the disease severity of septic shock and portends a grave prognosis. |
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Authors:
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Ming-Hung Tsai; Yung-Chang Chen; Jau-Min Lien; Ya-Chung Tian; Yun-Shing Peng; Ji-Tseng Fang; Chun Yang; Jui-Hsiang Tang; Yun-Yi Chu; Pang-Chi Chen; Cheng-Shyong Wu |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of critical care Volume: 23 ISSN: 1557-8615 ISO Abbreviation: J Crit Care Publication Date: 2008 Dec |
Date Detail:
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Created Date: 2008-12-05 Completed Date: 2009-06-22 Revised Date: 2010-03-31 |
Medline Journal Info:
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Nlm Unique ID: 8610642 Medline TA: J Crit Care Country: United States |
Other Details:
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Languages: eng Pagination: 468-72 Citation Subset: IM |
Affiliation:
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Division of Gastroenterology, Chang Gung Memorial Hospital, Chang Gung University, Taipei 105, Taiwan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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APACHE Aldosterone / blood Blood Gas Analysis Female Hemodynamics* Hepatitis B / complications Hospital Mortality Humans Lactic Acid / blood Liver Failure, Acute / complications, metabolism*, mortality, physiopathology* Male Middle Aged Renin / blood Shock, Septic / complications, metabolism*, mortality, physiopathology* |
| Chemical | |
Reg. No./Substance:
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50-21-5/Lactic Acid; 52-39-1/Aldosterone; EC 3.4.23.15/Renin |
| Comments/Corrections | |
Comment In:
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J Crit Care. 2008 Dec;23(4):473-4
[PMID:
19056009
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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