Hemodynamics and metabolic studies on septic shock in patients with acute liver failure

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

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Backgrounds: 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/cm5·m2), 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.

Original languageEnglish
Pages (from-to)468-472
Number of pages5
JournalJournal of Critical Care
Volume23
Issue number4
DOIs
Publication statusPublished - Dec 1 2008
Externally publishedYes

Fingerprint

Acute Liver Failure
Septic Shock
Hemodynamics
Preexisting Condition Coverage
Aldosterone
Renin
Liver Diseases
Lactic Acid
Oxygen
Liver Failure
Renin-Angiotensin System
Hospital Mortality
Oxygen Consumption
Vascular Resistance
Intensive Care Units
Veins
Sepsis
Gases
Mortality

Keywords

  • Acute liver failure
  • Hemodynamics
  • Septic shock
  • Tissue oxygenation

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Tsai, M. H., Chen, Y. C., Lien, J. M., Tian, Y. C., Peng, Y. S., Fang, J. T., ... Wu, C. S. (2008). Hemodynamics and metabolic studies on septic shock in patients with acute liver failure. Journal of Critical Care, 23(4), 468-472. https://doi.org/10.1016/j.jcrc.2008.04.006

Hemodynamics and metabolic studies on septic shock in patients with acute liver failure. / Tsai, Ming Hung; Chen, Yung Chang; Lien, Jau Min; Tian, Ya Chung; Peng, Yun shing; Fang, Ji Tseng; Yang, Chun; Tang, Jui-Hsiang; Chu, Yun Yi; Chen, Pang Chi; Wu, Cheng Shyong.

In: Journal of Critical Care, Vol. 23, No. 4, 01.12.2008, p. 468-472.

Research output: Contribution to journalArticle

Tsai, MH, Chen, YC, Lien, JM, Tian, YC, Peng, YS, Fang, JT, Yang, C, Tang, J-H, Chu, YY, Chen, PC & Wu, CS 2008, 'Hemodynamics and metabolic studies on septic shock in patients with acute liver failure', Journal of Critical Care, vol. 23, no. 4, pp. 468-472. https://doi.org/10.1016/j.jcrc.2008.04.006
Tsai, Ming Hung ; Chen, Yung Chang ; Lien, Jau Min ; Tian, Ya Chung ; Peng, Yun shing ; Fang, Ji Tseng ; Yang, Chun ; Tang, Jui-Hsiang ; Chu, Yun Yi ; Chen, Pang Chi ; Wu, Cheng Shyong. / Hemodynamics and metabolic studies on septic shock in patients with acute liver failure. In: Journal of Critical Care. 2008 ; Vol. 23, No. 4. pp. 468-472.
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abstract = "Backgrounds: 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/cm5·m2), 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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AU - Peng, Yun shing

AU - Fang, Ji Tseng

AU - Yang, Chun

AU - Tang, Jui-Hsiang

AU - Chu, Yun Yi

AU - Chen, Pang Chi

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N2 - Backgrounds: 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/cm5·m2), 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.

AB - Backgrounds: 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/cm5·m2), 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.

KW - Acute liver failure

KW - Hemodynamics

KW - Septic shock

KW - Tissue oxygenation

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