Hepatic failure

The liver has more, and more diverse, functions than any other major organ, including

■ nutrition (synthesis of plasma proteins, glucogenesis) ■ immunity ■ heat production ■ synthesis of homeostatic controls (most intrinsic clotting factors,

angiotensin 1) ■ detoxification (ammonia, drugs)

so hepatic failure affects most other major systems. However, symptoms of liver failure are less immediately apparent than respiratory, cardiac or renal dysfunction, so may be given low priority in ICU patients.