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Highly Accessed Review

Clinical review: The liver in sepsis

Nicolas Nesseler123, Yoann Launey123, Caroline Aninat23, Fabrice Morel23, Yannick Mallédant123* and Philippe Seguin123

Author Affiliations

1 Service d'Anesthésie-Réanimation 1, Hôpital Pontchaillou, 2 rue Henri Le Guilloux, 35033 Rennes, France

2 INSERM UMR-S 991, Hôpital Pontchaillou, 2, rue Henri Le Guilloux, 35033 Rennes, France

3 Université de Rennes 1, Faculté de Médecine, 2 avenue du Professeur Léon Bernard, 35033 Rennes, France

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Critical Care 2012, 16:235  doi:10.1186/cc11381

Published: 30 October 2012

Abstract

During sepsis, the liver plays a key role. It is implicated in the host response, participating in the clearance of the infectious agents/products. Sepsis also induces liver damage through hemodynamic alterations or through direct or indirect assault on the hepatocytes or through both. Accordingly, liver dysfunction induced by sepsis is recognized as one of the components that contribute to the severity of the disease. Nevertheless, the incidence of liver dysfunction remains imprecise, probably because current diagnostic tools are lacking, notably those that can detect the early liver insult. In this review, we discuss the epidemiology, diagnostic tools, and impact on outcome as well as the pathophysiological aspects, including the cellular events and clinical picture leading to liver dysfunction. Finally, therapeutic considerations with regard to the weakness of the pertinent specific approach are examined.