Journal ArticleDOI
Mechanism of hepatic dysfunction following shock and trauma.
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TLDR
The recent experience with this syndrome of marked jaundice following trauma prompted an investigation into its etiology, and the large number of factors involved in clinical cases made determination of the underlying mechanisms difficult.Abstract:
Mild jaundice is relatively common in patients who are recovering from major trauma. It is often attributed to the effect of multiple transfusions, transfusion reaction, absorption of blood from hematomas, or preexisting liver disease. Occasionally, the jaundice in such patients may be severe and may closely resemble obstructive jaundice. Examination to exclude obstructive jaundice may be hampered by postoperative abdominal tenderness, ileus, or depressed mental function due to head trauma. The effects of anesthesia and a wide variety of drugs must also be considered. Although hepatic dysfunction following trauma has been well described in the literature, the large number of factors involved in clinical cases has made determination of the underlying mechanisms difficult. Our recent experience with this syndrome of marked jaundice following trauma prompted an investigation into its etiology. Clinical Material Between January 1965 and January 1969, approximately 500 patients were admitted to San Francisco General Hospital with major,read more
Citations
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Journal ArticleDOI
Liver dysfunction in critical illness.
TL;DR: It is proposed that Kupffer cell phagocytic depression associated with liver dysfunction permits systemic spread of endotoxin and inflammatory mediators and thus predisposes to multiple organ failure.
Journal ArticleDOI
Incidence and prognostic importance of jaundice after cardiopulmonary bypass surgery
J. D. Collins,Robin E Ferner,A. Murray,Margaret F. Bassendine,A. Blesovsky,D.T. Pearson,Oliver F. W. James +6 more
TL;DR: Although PPJ was significantly associated with multiple valve replacement, higher transfusion requirements, and longer cardiopulmonary bypass time, it also occurred in patients undergoing uncomplicated operations and is suggested that PPJ is caused by a defect in hepatic excretion of bilirubin.
Journal ArticleDOI
Indocyanine Green: Its Use as an Early Indicator of Hepatic Dysfunction Following Injury in Man
TL;DR: Indocyanine green clearance was found to be an early and sensitive indicator of impaired hepatic function and preceded an increase in total serum bilirubin concentration to a mean value of 1.9 mg/dL.
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Hepatocellular dysfunction occurs early after hemorrhage and persists despite fluid resuscitation.
TL;DR: In vivo study demonstrates that active hepatocellular function is significantly depressed early after hemorrhage and persists despite resuscitation with RL and may form the basis of the MOF observed after severe and prolonged hemorrhage.
Journal ArticleDOI
Hepatocyte injury during post-operative sepsis: activated neutrophils as potential mediators.
John M. Holman,Thomas M. Saba +1 more
TL;DR: In vivo transient hepatic parenchymal cell injury with post‐operative sepsis may be mediated by the margination of activated PMNs in the liver.
References
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TL;DR: Aspiration liver biopsy and various biochemical tests have been utilized in this attempt to clarify some of the outstanding problems, and in many instances hemodynamic data were available from cardiac catheter studies.
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The national halothane study : a study of the possible association between halothane anesthesia and postoperative hepatic necrosis; report
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Biliary excretion of injected conjugated and unconjugated bilirubin by normal and Gunn rats
TL;DR: Conjugated and unconjugated bilirubin were injected intravenously at different times into normal rats and homozygous, jaundiced Gunn rats and as expected, Gunn rats did not excrete injected unconj...
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The role of shock in the production of central liver cell necrosis.
Max Ellenberg,Kermit E. Osserman +1 more
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Physiological and pathological responses in the blood‐vessels of the liver
TL;DR: The circulation in the intact liver and its reaction to various stimuli were studied in frogs, mice and rats by a modification of Knisely's transillumination technique, and the readiness with which it reacts to stimuli may have a significant bearing on the pathogenesis of liver diseases.