Derangement of liver function tests in critically ill patients

Aim and Objective: To determine the frequency of derangement of Liver Function Tests in critically sick patients admitted in high dependency unit. Patients and Methods: This is a prospective descriptive observational study done in high dependency unit of Pediatric Medical ward of The Children’s Hospital and the Institute of Child Health Lahore form October 2012 to March 2013. All sick patients aged one month to 12 years, admitted in high dependency area, were enrolled in the study. Patients having pre existing chronic liver disease were excluded from the study. A predesigned proforma was completed after taking parental consent. The proforma included a relevant history, clinical signs, laboratory results, interventions (if required) and outcome. All patients were given appropriate treatment and followed regarding their Liver Function Tests. All the data entered in to the SPSS-version 16 and results were analyzed in percentages. Results: A total of 100 patients were enrolled. Amongst them, there were 57% males and 43% females. Majority of the patients, 75 (75 %) were below 5 years and mean age was 34.25 months. Liver function tests were found to be deranged in 47% of sick patients and amongst them, most common causes were sepsis (46.8%), followed by tuberculosis (15%), Enteric fever (12.7%), CNS Infections (6.38%), bronchopneumonia (10.6%), acute watery diarrhea (4.2%), and others (2.1%). Conclusion: Among critically ill patients, 47% had early hepatic dysfunction and the commonest cause was sepsis. As deranged liver function tests have wide spread pathophysiological implications so in sick children of intensive care, they are considered as a major risk factor.