Liver Injury and Failure in Critical Illness

Abstract

The frequency of acquired liver injury and failure in critical illness has been significantly increasing over the last decades. Currently, liver injury and failure are observed in up to twenty percent of patients at the intensive care unit and are associated with significantly increased morbidity and mortality. Secondary forms of liver injury in critical illness are mainly divided in cholestatic, hypoxic or mixed forms. Therefore, key for a better understanding of clinical manifestations, prognostic implications as well as diagnostic and therapeutic options of acquired liver injury and failure is sufficient knowledge of underlying alterations (e.g. hemodynamic, inflammatory or drug induced). This review provides a structured approach for evaluation and treatment of acquired liver injury and failure in critically ill patients.