how many minutes papain exit system toxic shock liver

Elevation in liver enzymes and bilirubin can subside within days or deteriorate if persistent hepatic microcirculatory failure is present ( 9). Liver function is not affected by aging processes ( 11, 22, 23). Dynamic tests such as indocyanine green clearance are useful for monitoring perfusion and global liver function. The incidence of liver dysfunction may be underestimated if traditional static measures such as aminotransferase or bilirubin only be considered. Although these parameters have low sensitivity and specificity, they emerge as a result of hepatocellular or bill ducts injury and widely used to detect hepatic injury. A decrease in albumin and coagulation factors is the pivotal laboratory finding. Different grades of liver shock vary from mild elevation of serum aminotransferases and bilirubin levels in septic patients to an acute onset of high serum liver enzymes after hemodynamic shock ( 9, 18- 21). Failure of microcirculation, systemic inflammatory response and adverse effects of treatment in patients in intensive care unit are amongst other causes ( 9, 17).

Multiple mechanisms can cause hepatic shock including hemorrhage, major surgery, respiratory failure, infection and persistent shock. In most cases, liver dysfunction emerges without any noticeable changes in patients’ clinical profile ( 5, 12- 16). Transient elevation in serum hepatic enzymes occurs following a hypo-perfusion state termed “shock liver” or “hypoxic hepatitis” ( 4, 10, 11). Heart failure) and “hypoxic hepatitis” that results from hypoxic insults such as respiratory failure ( 3- 8), this condition is also termed “hypoxic hepatopathy” ( 9, 10). Hepatocytes hypoperfusion that causes liver cell injury is classified as “ischemic hepatitis” resulting from hemodynamic instability and inadequate blood flow due to reduced hepatic arterial flow and/or passive venous congestion (e.g. “Shock liver” otherwise known as ischemic hepatitis is believed to be due to reduction in systemic blood flow as occurs in shock ( 2). Liver is the only parenchymal organ with dual blood flow, from portal vein and hepatic artery ( 1). It is the place of metabolism and clearance and the blood volume reservoir. Liver acts as the factory of bio-synthetics.

How many minutes papain exit system toxic shock liver