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Events taking place in decompensated liver failure

Authoring team

The events may be as a result of some degree of hypoxia caused by hypovolaemia as a result of haemorrhage or diuresis. The putative sequence of events includes:

  • metabolic acidosis caused by metabolic dysfunction of hepatocytes (high levels of serum lactate, usually metabolised in the liver)

  • shunting of blood away from the liver, perhaps as a step causing the metabolic acidosis, with regions of relative anoxia within the cirrhotic nodules

  • entry of compound usually removed by the liver into the circulation, with effects on organs such as the brain, causing encephalopathy, and kidneys which may result in ascites and impaired renal function

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