Rol del hígado en la encefalopatía séptica. Un desorden vinculado a la disfunción orgánica múltiple de la sepsis.

The appearance of jaundice during a septic process is usually associated to multiple organ failure and a high mortality rate. Among 17 septic patients followed prospectively, we found 11 with hepatic dysfunction. Abnormal levels of bilirubin and alanine-aminotransferase were found. Glutamine concentration in spinal fluid was 26 +/- 19.4 mg/dl vs 9.43 +/- 2.41 in patients without liver failure (p less than 0.05). Significant correlations were found among levels of bilirubin and glutamine (r = 0.83), creatinine (r = 0.708), number of platelets (r = 0.778) and between glutamine and creatinine (r = 0.708). Patients with liver failure presented a higher rate of renal failure and thrombocytopenia (p less than 0.01) and a higher mortality rate. These findings confirm that liver failure is associated to multiple organ failure and thrombocytopenia. It may be related to small vessel occlusion.