Effects of grade B liver dysfunction on the level of free hexafluoroisopropanol of sevoflurane metabolites in patients with abdominal surgery

Abstract Background: Study shows the metabolite, hexafluoroisopropanol (HFIP) from sevoflurane, has a strong inhibition on the central nervous system. This study aims to compare the level of free HFIP in the blood after inhaled a same concentration of sevoflurane in patients with normal liver function versus grade B liver dysfunction and observe its effect on patients’ recovery quality.Methods: Twenty four patients with normal liver function and twenty four patients with grade B liver dysfunction undergoing elective abdominal surgery were selected and assigned to group A and group B, respectively. All patients were inhaled sevoflurane (1.5MAC) for anesthesia about 3 h. The free HFIP concentration was determined at the time points of 0.5 h, 1 h, 2 h, 3 h after inhaled sevoflurane and 0.5 h, 1 h, 2 h, 4 h after discontinuation of sevoflurane, respectively. Patients’ eyes opening time, orientation recovery time, command response time and extubation time were observed after operation. The visual analogue scale (VAS) and Ramsay sedation score (RSS) were also evaluated at different time points after extubation. Results: Although the peak time of free HFIP in group B was 1 h later than that in group A, no significant differences were found in the peak concentration and other corresponding time points’ free HFIP concentrations between the two groups (P<0.05). All the eyes opening time, orientation recovery time, command response time and extubation time in group B were longer than those in group A (P<0.05). Compared to group A, a lower VAS score and a higher RSS score were found in group B at 0 min, 15 min, 30 min,1 h, 2 h and 3 h after extubation, respectively (P<0.05). Conclusion: The status of patients with grade B liver dysfunction does not affect the degree of sevoflurane metabolism. However, it can significantly prolong the peak time of free HFIP when compared with normal liver function.Trial registry number: Identified as ChiCTR 2000028901at http://www.chictr.org.cn/

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Volumetric Assessment and Clinical Predictor of Cirrhotic Livers With Normal Liver Function Undergoing Hepatectomy

10.21203/rs.3.rs-513177/v1 ◽

2021 ◽

Author(s):

Takayuki Shimizu ◽

Taku Aoki ◽

Kyung-Hwa Park ◽

Takatsugu Matsumoto ◽

Takayuki Shiraki ◽

...

Keyword(s):

Liver Function ◽

Parenchymal Cell ◽

Liver Volume ◽

Volume Ratio ◽

Normal Liver ◽

Cirrhotic Liver ◽

Liver Pathology ◽

Normal Liver Function ◽

Liver Parenchymal Cell ◽

Group A

Abstract Aim: Indocyanine green retention rate at 15 minutes (ICGR15) is a frequently-used indicator of liver function. However, cirrhotic liver is sometimes observed intraoperatively despite a normal preoperative ICGR15 (<10 %). Herein, we conducted clinical and volumetric assessments of cirrhotic livers with normal ICGR15.Methods: Patients undergoing hepatectomy for hepatocellular carcinoma were divided into 3 groups: non-cirrhotic livers (Group A, n=112): cirrhotic livers with ICGR15 <10% (Group B, n=71): and cirrhotic livers with ICGR15 >10% (Group C, n=296). Background characteristics and surgical outcomes were compared between groups. Functional liver volume (FLV) was computed using total liver volume and signal intensity ratio. Liver parenchymal cell volume ratio was measured in non-cancerous tissue obtained from resected specimens. Univariate and multivariate analyses were performed to detect clinical characteristics correlating with cirrhotic liver pathology with normal ICGR15.Results: There was no significant difference between groups in TLV. FLV was gradually reduced from Group A toward Group C. Liver parenchymal cell volume ratio was also gradually reduced from Group A toward Group C. Multivariate analysis revealed that platelet count (<12 x104/mm3) (P = 0.001) and prothrombin time (<80 %) (P = 0.025) were significantly associated with cirrhotic liver pathology among patients with normal ICGR15.Conclusion: Our results suggested that cirrhotic liver pathology despite normal liver function was characterized by slightly decreasing liver parenchyma as well as slight degree of fibrosis. Platelet count and PT% are useful for predicting liver cirrhosis with normal ICGR15.

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The Pattern of Liver Dysfunction in Patients with COVID-19: A Retrospective Study

10.21203/rs.3.rs-42863/v1 ◽

2020 ◽

Author(s):

Chunyan wang ◽

Yihui Rong ◽

Lei Wei ◽

Huanwei Zheng ◽

Jing Xu ◽

...

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Liver Function ◽

Liver Dysfunction ◽

Normal Liver ◽

Normal Liver Function ◽

Viral Shedding ◽

Type 3

Abstract Background. Information about liver dysfunction in patients with COVID-19 is scarce. We aimed to explored the pattern and risk factors of liver dysfunction in patients with COVID-19.Methods. In this retrospective study, we included all consecutive confirmed patients with COVID-19 in Fuyang Second People’s Hospital between January 20 and February 25, 2020 and collected clinical characteristics until discharge. The pattern and risk factors of liver dysfunction, viral shedding and outcome were analyzed.Results. Totally, 146 patients were analyzed. The median age was 44.9 years and 54.1% were men, 43.8% patients presented liver dysfunction (22.6% on admission, 21.2% during hospitalization). The percentage of elevated ALT (15.1% on admission and 24.7% during hospitalization) were significantly higher than ALP (2.1% on admission and 3.4% during hospitalization) (P < 0.001). Four clinical types were identified, type 1 (persistent normal liver function, 56.2%), type 2 (normal liver function on admission developed to liver dysfunction during hospitalization, 21.2%), type 3 (liver dysfunction on admission restored to normal on discharge, 13.0%) and type 4 (persistent liver dysfunction, 9.6%). The median duration of viral shedding was 12.0 (type 1), 15.0 (type 2), 14.0 (type 3) and 18.0 (type 4) days (P < 0.001). Prolonged viral shedding and severity were potential risk factors associated with liver dysfunction. Conclusions. The incidence of liver dysfunction in patients with COVID-19 is common but not severe, which mainly due to SARS-CoV-2-mediated immune injury on hepatocyte rather than cholangiocyte, DILI and underlying chronic liver disease should not be neglect.

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Normal hepatic function

10.1093/med/9780199568741.003.0207 ◽

2018 ◽

Author(s):

Satish Keshav ◽

Palak Trivedi

Keyword(s):

Liver Function ◽

Liver Dysfunction ◽

Functional Anatomy ◽

Normal Liver ◽

Hepatic Function ◽

Lymphatic Drainage ◽

Normal Liver Function ◽

Biliary Anatomy ◽

Liver Anatomy ◽

Normal Hepatic Function

This chapter explores normal liver function, including liver anatomy (vasculature, biliary anatomy, lymphatic drainage, innervation of the liver, and functional anatomy of the liver), basic physiology, and mechanisms of liver dysfunction.

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Forefront of the viral chronic hepatitis treatment. Treatment of the case for which the treatment plans can not be decided. 5. Treatment for the case of normal liver function.

Kanzo ◽

10.2957/kanzo.45.413 ◽

2004 ◽

Vol 45 (8) ◽

pp. 413-417

Author(s):

YUJIN MINAMI

Keyword(s):

Chronic Hepatitis ◽

Liver Function ◽

Normal Liver ◽

Normal Liver Function ◽

Hepatitis Treatment ◽

Treatment Plans

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An Investigational Study of BMS-986165 in Participants With Normal Liver Function and Participants With Mild, Moderate and Severe Liver Damage

Case Medical Research ◽

10.31525/ct1-nct03890809 ◽

2019 ◽

Author(s):

Keyword(s):

Liver Function ◽

Liver Damage ◽

Normal Liver ◽

Normal Liver Function ◽

Severe Liver ◽

Severe Liver Damage

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Management of Obscurely Dilated Common Bile Duct with Normal Liver Function Tests: A Pragmatic Approach

World Journal of Surgery ◽

10.1007/s00268-021-06175-4 ◽

2021 ◽

Author(s):

Sundeep Singh Saluja ◽

Vaibhav Kumar Varshney ◽

Vidya Sharada Bhat ◽

Phani Kumar Nekarakanti ◽

Asit Arora ◽

...

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Liver Function ◽

Normal Liver ◽

Liver Function Tests ◽

Pragmatic Approach ◽

Normal Liver Function ◽

Function Tests

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Effect of supplemental dexmedetomidine in interventional embolism on cerebral oxygen metabolism in patients with intracranial aneurysms

Journal of International Medical Research ◽

10.1177/03000605211002960 ◽

2021 ◽

Vol 49 (4) ◽

pp. 030006052110029

Author(s):

Zhang Guo ◽

Weiwei Wang ◽

Dahua Xie ◽

Ruisheng Lin

Keyword(s):

Intracranial Aneurysms ◽

Jugular Vein ◽

Oxygen Metabolism ◽

Cerebral Oxygen ◽

Cerebral Oxygen Metabolism ◽

Time Points ◽

Venous Oxygen Saturation ◽

Group A ◽

Group B ◽

Oxygen Difference

Objective To investigate the effect of supplemental dexmedetomidine in interventional embolism on cerebral oxygen metabolism in patients with intracranial aneurysms. Methods Ninety patients who underwent interventional embolism of intracranial aneurysms were equally divided into Group A and Group B. In Group A, dexmedetomidine was injected intravenously 10 minutes before inducing anesthesia, with a loading dose of 0.6 µg/kg followed by 0.4 µg/kg/hour. Group B received the same amount of normal saline by the same injection method. Heart rate (HR), mean arterial pressure (MAP), arterial–jugular venous oxygen difference [D(a-jv) (O2)], cerebral oxygen extraction [CE (O2)], and intraoperative propofol use were recorded before inducing anesthesia (T0) and at five time points thereafter. Results The amount of propofol in Group A was lower vs Group B. At all five time points after T0, HR, MAP, D(a-jv) (O2), and CE (O2) in Group A were significantly lower vs Group B, with significant differences for jugular venous oxygen saturation (SjvO2) and the oxygen content of the internal jugular vein (CjvO2) between the groups. Conclusion Dexmedetomidine resulted in less intraoperative propofol, lower D(a-jv) (O2) and CE (O2), and improved cerebral oxygen metabolism.

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Persistently raised aspartate aminotransferase (AST) due to macro-AST in a rheumatology clinic

Diagnosis ◽

10.1515/dx-2014-0065 ◽

2015 ◽

Vol 2 (2) ◽

pp. 137-140 ◽

Cited By ~ 2

Author(s):

Wycliffe Mbagaya ◽

Joanne Foo ◽

Ahai Luvai ◽

Claire King ◽

Sarah Mapplebeck ◽

...

Keyword(s):

Liver Function ◽

Aspartate Aminotransferase ◽

Normal Liver ◽

Abdominal Ultrasound ◽

Liver Function Tests ◽

Analytical Investigation ◽

Normal Liver Function ◽

Rheumatology Clinic ◽

History Of ◽

Liver Biopsies

AbstractMacrocomplexes between immunoglobins and aspartate aminotransferase (macro-AST) may result in persistently increased AST concentration. The presence of macro-AST in patients has been implicated in unnecessary investigations of abnormal liver function tests. We report the case of a 44-year-old female who presented to the rheumatology clinic with a 12-months’ history of constant widespread pain affecting her limbs and was found to have an elevated AST concentration. Further information from her GP revealed a 14-years’ history of elevated AST with otherwise normal liver function. Previous abdominal ultrasound and two liver biopsies carried out 2 years apart were normal. This prompted further analytical investigation by the biochemistry department which identified macro-AST as the cause. This case illustrates that persistently raised isolated AST concentration with no other abnormal indices may warrant macroenzyme analysis potentially avoiding unnecessary invasive investigations.

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