[HSF] Hepatic protective strategies

[Prasanna Simha M]

He had an enlarged liver and while he had some peroperative increase in INR
it normalized with VitK. He had an increase in PT later on in the period but
that was quite preterminal when he was going into encephalopathy and not at
the  initial phase. I really was confused and was tempted to think of drug
induced cholestasis etc but it did not fit into the picture. In fact I first
thtiought it may be Cordarone induced cholestasis and stopped all drugs with
potential hepatotoxicity.There was no hepatobilary radicular dilatation to
suggest post hepatic causes too.
As I said things were not fitting very well with him wrt classical liver
failure.
All I can think was some enzyme systems were more effected than the others.
He progressed to a value of 24 mg/dL and I do not have access to Hepatic
filtration etc. We gave him things like Agar agar and tried to manage him
with high hydration diuresis to get as much of direct bilirubin  flushed out
via the kidneys but while it transiently got it down for some time the rise
was unstoppable.
Prasanna
On 1/3/07, erdinç naseri <enaseri at hotmail.com.tr> wrote:
>
>
> Dear Dr. Prasanna ,
> I have 2 questions regarding this patient:
> 1.Since there is no increase in HFT except bilirubin leve,l was he a
> cardiac
> cirrhotic patient?
> 2.If yes ,how do you explain normal PT?
>
> Erdinc naseri
>
>
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-- 
Prasanna Simha M