الفهرس 
Anatomy and physiology of the liverOnly 14 pages are availabe for public view
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Abstract
Liver dysfunction is frequently observed in critically ill patients. Its occurrence is associated with high morbidity and mortality. The most frequent entities of hepatic dysfunction in ICU are shock liver and cholestatic liver dysfunction with incidence rates up to 10 and 30%, respectively. Both conditions are frequently triggered by hypoxic and/or ischemic events, most commonly cardiogenic shock and sepsis/septic shock. Apart from chronic liver diseases and malignancies, iatrogenic factors such as total parenteral nutrition, surgical procedures, drugs and blood transfusions promote its occurrenceEarly recognition and subsequent therapy of the underlying conditions are still the therapeutic cornerstones. The mainstay of clinical management of liver injury in the ICU is related to early diagnosis and correct identification of etiology. The ideal treatment of acute liver failure and HRS is the liver transplantation, however, because of the long waiting lists in the majority of transplant centers, most patients die before transplantation. The severity of liver disease can best be assessed by the Child-Turcotte-Pugh (CTP) score and MELD score.
Conclusion: In critically ill patients, hypoxic, toxic, and inflammatory insults can affect hepatic excretory, synthetic, and/or purification functions, leading to systemic complications such as coagulopathy, increased risk of infection, hypoglycemia, and acute kidney injury. In severe cases, hepatic encephalopathy or brain dysfunction (acute liver failure) may occur.