Up to 70% of ICU patients will experience some form of organ malfunction or failure throughout their stay. Inadequate organ function must be restored for there to be any hope of a positive outcome, while the progressive failure of secondary organs might raise the risk of death. In the 1970s, hepatic encephalopathy within 8 weeks of a severe liver injury was considered diagnostic of “acute liver failure,” a condition that is both uncommon and potentially treatable in the absence of preexisting liver disease. In “Multiple Organ Dysfunction Syndrome,” the immunologic, regulatory, and metabolic roles of liver parenchymal and non-parenchymal cells make liver dysfunction an essential event. Acute-on-Chronic Liver Failure is characterized by the rapid deterioration of preexisting (chronic) liver disease or by acquired liver injury in the absence of underlying liver disease. It is difficult to get insight into the multifaceted nature of metabolic and immunologic liver dysfunction using traditional test markers such as transaminases or bilirubin. In addition, estimates of their prevalence vary greatly due to inconsistencies in how they are defined. To better comprehend liver dysfunction as a perpetrator (and therapeutic target) of multiple organ dysfunction syndromes in intensive care, we analyze the various classifications used to describe this condition.

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-022-04163-1