‘Liver function tests’ on the intensive care unit: a prospective, observational study

2009 ◽  
Vol 35 (8) ◽  
pp. 1406-1411 ◽  
Author(s):  
S. J. Thomson ◽  
M. L. Cowan ◽  
I. Johnston ◽  
S. Musa ◽  
M. Grounds ◽  
...  
2011 ◽  
Vol 39 (6) ◽  
pp. 1056-1063 ◽  
Author(s):  
S. J. G. M. Ahlers ◽  
L. van Gulik ◽  
E. P. A. van Dongen ◽  
P. Bruins ◽  
D. Tibboel ◽  
...  

A volunteer study suggested that taking paracetamol 4 g daily could result in elevated alanine aminotransferase plasma levels in a substantial proportion of healthy volunteers. The safety of this dose of paracetamol for acute postoperative pain remains controversial. This study aimed to examine the incidence of alanine aminotransferase elevations after short-term use of paracetamol 4 g daily, as part of the standard pain management protocol, for 93 consecutive patients after cardiothoracic surgery. Alanine aminotransferase levels and other liver function tests were measured preoperatively as baseline and once daily after surgery during the intensive care unit stay. Preoperative alanine aminotransferase levels of more than one time the upper limit of normal (ULN, >40 U/l) was observed in 11% (n=10) of the patients but none of these baseline alanine aminotransferase levels exceeded three times the ULN (>3×ULN). The average daily dose of paracetamol administered was 50 mg/kg (SD=16) after surgery. Postoperative alanine aminotransferase levels of >1×ULN was observed in 17% (n=16), and 4% (n=4) exceeded >3×ULN. The other liver function tests of the latter four patients, including aspartate aminotransferase (range 173 to 5590 U/l), γ-glutamyltransferase (range 56 to 103 U/l), lactate dehydrogenase (range 376 to 3518 U/l) and the International Normalised Ratio (range 2.0 to 6.6), were all abnormal. These four patients all had right ventricular failure or cardiogenic shock during the postoperative period which could explain the significant rises in alanine aminotransferase after surgery. In conclusion, the incidence of significant alanine aminotransferase elevations after using daily paracetamol as an analgesic agent for cardiac surgery, at a dose of 4 g per day, was low and mostly due to complications after surgery. Our results, albeit still very limited, provided some reassurance about the safety of paracetamol 4 g daily, as a supplementary analgesic agent for adult patients undergoing cardiac surgery.


2020 ◽  
Vol 40 (10) ◽  
pp. 2394-2406 ◽  
Author(s):  
Salvatore Piano ◽  
Andrea Dalbeni ◽  
Elia Vettore ◽  
Devis Benfaremo ◽  
Massimo Mattioli ◽  
...  

2021 ◽  
Vol 7 (3) ◽  
pp. 211-216
Author(s):  
Adina Roman ◽  
Septimiu Moldovan ◽  
Ario Santini ◽  
Mircea Stoian ◽  
Daniela Dobru

Abstract Introduction: The World Health Organization (WHO) identified a novel coronavirus, originating in Wuhan, China, in December 2019, as a pneumonia causing pathogen. Epidemiological data in Romania show more than 450.000 confirmed patients, with a constant number of approximately 10% admission in intensive care unit. Method: A retrospective, observational study was conducted from 1st March to 30th October 2020, comprising 657 patients, confirmed as having COVID-19, and who had been admitted to the intensive care unit of the Mures County Clinical Hospital, Tîrgu Mures, Romania, which had been designated as a support hospital during the pandemic. Patients who presented at admission or developed abnormal liver function tests in the first seven days of admission, were included in the study; patients with pre-existing liver disease, were excluded. Results: The mean (SD) age of patients included in the study was 59.41 (14.66) years with a male: female ratio of 1.51:1. Survivor status, defined as patients discharged from the intensive care unit, was significantly associated with parameters such as age, leukocyte count, albumin level, glycaemia level (p<0.05 for all parameters.) Conclusions: Liver injury expressed through liver function tests cannot solely constitute a prognostic factor for COVID-19 patients, but its presence in critically ill patients should be further investigated and included in future guideline protocols.


Mycoses ◽  
2011 ◽  
Vol 55 (1) ◽  
pp. 73-79 ◽  
Author(s):  
Anna Maria Tortorano ◽  
Giovanna Dho ◽  
Anna Prigitano ◽  
Giuseppe Breda ◽  
Anna Grancini ◽  
...  

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