Anestesia en el paciente con alteración de la función hepática

Sabaté, Antoni; Villegas, Fernando; Dalmau, A.; Koo, Maylin; Sánchez, T. Sansano; Palenciano, C.G

doi:10.1016/s0034-9356(11)70142-6

Cited by 7 publications

(2 citation statements)

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“…In animal models, Fas-mediated mitochondrial changes and apoptosis also point to hepatic injury due to oxidative stress [ 25 ]. In our population, a high percentage of patients had had surgery (79.6%) and, therefore certain levels of oxidative stress associated with the surgery itself as well as with anesthesia [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors of hepatic function alterations in hospitalized adult patients treated with short-term parenteral nutrition receiving the same lipid composition at the same dose

et al. 2018

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BackgroundHigh doses and vegetable origin of lipid emulsions (LE) are prominent factors for liver test (LT) alterations in patients treated with parenteral nutrition (PN). This study aims to determine incidence of LT alterations, and risk factors related to these alterations in patients with short term PN with homogenous LE.MethodsAdult non-critically ill hospitalized patients, with normal LTs at the beginning of PN, receiving 0.8 g/kg/day of an olive/soybean LE were included. A paired Student t-test was applied to compare final with initial LT values. LT variation (end vs start of PN) according to type of surgery and infection was studied by means of an analysis of the variance. Univariate and multivariate analyses were constructed to relate the variations of each of the 4 LTs with the adjustment variables.ResultsOne hundred eighty one patients (66.57 ± 12.89 years; 72.4% men), 66.8% suffered from cancer. Final LT values increased from initial values for gamma-glutamyltransferase (GGT) 2.69 ± 2.49 μkat/L vs 0.55 ± 0.36 μkat/L, alkaline phosphatase (AP) 1.97 ± 1.49 μkat/L vs 1.04 ± 0.33 μkat/L, and alanine aminotransferase (ALT) 0.57 ± 0.92 μkat/L vs 0.32 ± 0.26 μkat/L. GGT and AP variations were associated with days of PN; GGT, AP and total bilirubin with surgical patients, AP variations with infection, and GGT with cancer. Multivariate analysis: elevation of GGT, AP and ALT was related to infection, days of PN and surgery.ConclusionsFactors that increased the risk of LTs elevation during short term PN treatment were duration of PN, surgery, cancer, and infection associated with oxidative stress.

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Section: Discussionmentioning

confidence: 99%

Risk factors of hepatic function alterations in hospitalized adult patients treated with short-term parenteral nutrition receiving the same lipid composition at the same dose

et al. 2018

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“…On the other hand, patients classified as Child C or with a MELD score greater than 20, are at a high risk for anesthesia, and elective surgeries are contraindicated in this group. 3…”

Section: Introductionmentioning

confidence: 99%