CHANGES OF LIVER SIZE AND ITS FUNCTION IN CRITICALLY ILL PATIENTS AT PEDIATRIC INTENSIVE CARE UNIT | ||||
| Al-Azhar Journal of Pediatrics | ||||
| Article 9, Volume 23, Issue 4, October 2020, Page 1392-1406 PDF (197.95 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/azjp.2020.128819 | ||||
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| Abstract | ||||
Introduction: Critical illness may result in hepatic injury due to alterations in hemodynamic and oxygen delivery and metabolic derangements. This may result in alteration of liver size as well as impairment of important liver functions. Aim of the study: to Study liver size changes during the period of admission into PICU and its correlation with AST, ALT and CRP. Patients and Methods: 50 Patients were recruited from PICU at Sayed-Galal-University Hospital in the period from February to July 2020. All patients admitted to PICU were included in our study unless they did not fulfill the inclusion criteria. - Patients were examined clinically and investigated by AST,ALT and CRP - Clinical and laboratory Follow up weekly were done including ALT, AST and CRP. - Pelvi-abdominal ultrasound was done when any changes of its size detected clinically. Results: Total number of studied patients was 50, the most common indication of admission was Respiratory problems which constitute 44% followed by surgical problems about 28% while neurological problems in 16% and 12% were cardiac problems. 15 children (30%) of study patients had hepatomegaly according to age with mean liver span on admission 11.57±1.9 that increased after one week to 13.37±2.3 but did not show significant changes after two weeks as the mean was 13.86 ± 3.39. The studied patients had elevated ALT, AST and CRP above upper level of normal with percentage 58%, 56 and 62% consequently. Conclusion: Hepatomegaly and abnormalities of liver enzymes is a common finding in PICU especially in patients suffering from pneumonia and heart failure. Patients with hepatomegaly and altered hepatic function admitted to PICU carry a bad prognosis with long hospital stay, requirement of mechanical ventilation, inotropic support and they have a high mortality rate than those without hepatomegaly. | ||||
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