ABSTRACT

The hepatobiliary system plays a major role in energy metabolism, bilirubin metabolism, coagulation, digestion, and the immune response. The liver receives a large portion of the cardiac output and, as such, critically ill patients with any combination of trauma, hemodynamic instability, and sepsis are subject to hepatic dysfunction. Most critically ill patients are administered multiple medications which may affect hepatic function, and hepatic dysfunction may require alterations in drug dosing. Knowledge of the etiologies of hepatic dysfunction, hepatic function in disease states, and alterations in drug metabolism in the critically ill patient will aid the clinician in the generalized support of the critically ill patient with hepatic dysfunction.