The Liver and Shock

Hyperbilirubinemia as a Risk Factor for Mortality and Morbidity in Trauma Patients

“…Several laboratory studies have provided evidence that hypotension can lead to liver dysfunction. Shoemaker et al reported that the resistance to blood flow through the liver increased during shock [ 33 ], and Smith et al found that portal vein flow decreased [ 34 ]. Brauer et al suggested that hepatic excretion disorders occurred due to hepatic hypoperfusion [ 35 ].…”

The Liver as the Site of a Toxic Factor in Experimental Shock

“…That the liver is particularly vulnerable in shock has been an observation of many workers [21,24,26], Since hepatic blood flow is greatly reduced in shock states, failure of its detoxifying properties may be the result of prolonged anoxia thus permitting the accumulation of toxic products within the confines of this organ. The functional failure of the liver as a possible source of the debacle was originally suggested by Fine el al.…”

Hepatic Vascular Response to Endotoxin

“…Due to its strategic location between the portal and caval circulation, the liver presumably receives the highest concentration of gut toxins. Since the liver has the dual ability to sequester and detoxify endotoxin, it plays a major role in safeguarding the heart and systemic circulation (3). If, however, endotoxemia is prolonged and severe, the liver vasculature suffers marked damage which may so impair liver function as to contribute to the progression of irreversible shock (4).…”