Liver failure


Liver failure

Description liver failure

The liver is the largest and heaviest gland with the external body, weighs an average of around 1.5 kilograms. It ranks among the tissues with external secretion related to the digestive tract, but their functions are far mnohočetnější and extremely important. Located right in the middle of the abdomen, they are protected by the ribs and under normal circumstances and in full health does not exceed the line twelfth, ie the last rib. They consist of a right and left lobe, have a dark red-brown color, are soft to the touch pliant but relatively brittle when vibration or shock easily occurs tearing and human is threatened massive bleeding, since the liver is a very good blood supply and are also venous outflow He is rich. On the surface they are covered by the stationary fibrous sheath. In the abdominal cavity they are partly to adhere to a diaphragm, partly hung on the inferior vena cava and is partly maintained their position and with the support of other abdominal organs. Liver is also unique in its regenerative capacity. Fully able to fulfill its function as well as 1/5 of the liver. They also have the ability to liver after partial removal to grow back to its original size. Its basic function is detoxification of foreign substances using specialized cellular structures in the liver cells.Another important function is the charging task liver – stored here sugar glucose as glycogen, to be used in case of starvation first reserve material before they begin the grease. It is stored there and vitamin A, iron, vitamin B12, copper. Liver produces bile acids, the main component of bile and bile ducts through it transported to the gallbladder, which store the fed and washes into the small intestine and here helps digestion of fats.

Thanks are ongoing intense liver metabolism warmest organ in the body, consume up to 12% oxygen in each cardiac volume ejected per minute, and the blood flowing out of them is at a temperature of about 40 degrees Celsius. The portal vein that collects blood enriched with nutrients from food from the stomach and intestines that leads to the liver for processing and conversion basically everything that we eat. Into their metabolic cycles are entering sugars, fats, degrades herein cholesterol synthesized proteins herein, bile acids, vitamin K, some substances affecting blood clotting, one of the steps to funkčího state here undergoes vitamin D and certain steroid hormones from the adrenal gland.

Detoxifying function of the liver is completely irreplaceable. Degrade here all the foreign substances into the body are incorporated in any way, ie drugs, alcohol, drugs, poisons, but also substances produced in the body – degraded there during from broken red blood cells, are transformed are proteins and disintegrated proteins form urea which is then excreted by the kidneys, eliminates ammonia here, break down hormones here. Only liver cells are from whole body equipment for degradation and conversion of foreign compounds. Their main task is to transform substances into less toxic and more water soluble and thus facilitate their exclusion bile, feces and especially in urine.

Liver failure is a condition in which the liver is unable to perform its functions and creates distortions on the vital functions of the whole organism as a result of exposure to harmful substances various organs.

Symptoms of liver failure

Liver failure is the final phase, a sort of culmination of the toughest or the degree of liver insufficiency, which are in various degrees of individual liver function and when it is at the same time also reduced liver function reserve. The whole problem of failure is very complicated and complex, so there will be listed only some of the symptoms, without more dismantled. Failures are divided by the speed of onset of acute and chronic.

Acute renal failure is caused by inflammation of the liver severely ongoing, hepatitis, popularly known as jaundice, poisoning substances toxic to the liver, typically agaric, severe circulatory disorders (heart failure), extensive tumor or severe damage fatness liver (steatosis).

The chronic failure stands mostly cirrhosis, or nodular reconstruction of the liver, where functional tissue is separated by fibrous bands and there is a knotty rebuilding liver and breach of bloodstream. Cirrhosis (hardening of the liver) is usually the result of long-term liver disease, it is actually imperfect healing of the liver cells, when instead of functional tissue comes fibrous “scar”.During the onset of symptoms and consequences of a failure to apply two factors – the deterioration of the function of liver cells as a result of their loss and degradation of the remaining cells and high blood pressure in the portal vein with the formation of collateral circulation. Under normal status, portal vein leads to a lot of processing substances from the digestive tract and “cleaned” blood drain from the liver hepatic vein into the inferior vena cava and then into the heart for oxygenation. If the bloodletting worsened flow problem in the liver or liver failure in the drainage veins, blood accumulates and tries to overprinting into the inferior vena cava venous connections that are normally closed. The problem is that to couplings receives blood that has not undergone detoxification process and thus circulation then is pumped “polluted” blood. Excess pressure in the portal vein leads to impaired outflow of the organs of the digestive system and lead to engorgement jeich walls, impaired nutrient absorption, mucosa is more susceptible to bleeding and ulceration.

The most serious symptom of liver failure, whether the cause of the fault portal vein or inability to liver cells, the hepatic encephalopathy and coma. This is a disorder of brain function as a result of exposure nezmetabolizovaných substances that act directly on the brain tissue. A distinction isacute form associated with sudden liver failure and chronic form, behind which stands the emergence of several causes, especially significant collateral circulation is aided by a poor diet, or bleeding into the digestive tract. In both cases the brain receiving the aromatic amino acids and ammonia, which is highly toxic nerve cells and cause chaos in the transmission of information in the brain. The brain loses its ability to control, comes to brain swelling, seizures and coma, a state without medical intervention ends in death. Acute and chronic forms are differentiated according to the time between the appearance of jaundice and encephalopathy. In the acute form is a day to three weeks, in chronic forms a few weeks. Inclusion of the patient to a particular group is mainly prognostic significance. For failure due to chronic diseases prevalent initially nonspecific symptoms such as fatigue and nausea. Later comes the yellow discoloration of the skin, diminishing the liver develops bleeding from mucous membranes, increasing the temperature and increasing the number of beats with a fall in blood pressure. A serious consequence of a congestion of the mucous membranes of the digestive tract, ease of formation and possible bleeding přetup bacteria through the intestinal wall. In liver failure often we find the presence of fluid in the abdominal cavity, known as ascites. The cause of the altered blood drainage conditions, increased retention of sodium and water and reduced renal perfusion. Patients with liver failure are anemic, they suffer therefore anemia tend to bleed due to impaired synthesis of the factors involved in normal blood clotting, appearing with them a complex disorder of insufficient degradation of hormones (diabetes – insensitivity to insulin, breast enlargement and problems with potency in men – poor degradation of estrogens, both sexes complaining of reduced libido) decreases blood proteins are not in sufficient quantities formed in the liver cells, naručení fat metabolism lead to fatty liver, lack of bile production, or a broken drain leads to impaired degradation fats in the intestine.

Treatment of liver failure

It is a complex and individual. Each patient is hospitalized in the intensive care unit and in the first place is to odtsranit any precipitating causes of failure while supporting the residual liver function. It is necessary to ensure sufficient supply of eneregetický correctly selected ratio of nutrients and vitamins, it must be adapted to take fluids and acid-base balance. It is important to calm the digestive tract mucosa, which are prone to bleeding, non-absorbable antibiotic administered to clean the gut bacteria, are administered plasma derivatives to regulate blood clotting and protein administered drugs decreasing brain edema. All interventions give us time to prepare the patient for a possible liver transplant, if the patient is recommended.

How can I help myself

It consists in preventing all-inducing causes. Above n epithet alcohol, chronic alcoholism leads to cirrhosis, gather only mushrooms that we know, every year a number of people hospitalized with acute liver failure after eating poisonous mushrooms. It’s good to be vaccinated against hepatitis B and avoid contact with people who are at risk of incidence of hepatitis C, letting you check your liver tests in the use of certain drugs (typically in the treatment of tuberculosis), nenadužívat medicines containing paracetamol (Paralen), children up to 12 years not to put drugs containing acetylsalicylic acid (Aspirin), carefully work with toxic substances such as carbon tetrachloride, aniline and phosphorus, while traveling to exotic countries pay attention to food and drink (parasites). Also, some teas have a devastating effect on the liver. But there are reasons for liver failure prevention can not influence, but again we can accelerate that they came from, if not build to ignore the signs. These causes include blockage of the portal vein blood clot congenital malformation of veins contested liver cancer, some types of leukemia, obstruction of hepatic vein blood clots.

Complications of liver failure

Regarding hepatic encephalopathy, a major complication include a low percentage of survival. Worse in the elderly and in children under 10 years. For recurring conditions where a patient ends up with a diagnosis of encephalopathy, patients are at risk of dementia. In cirrhosis of the liver is a major complication of reconstruction and irreversible loss of liver function. Patients complain of muscle weakness, tiredness, fatigue, constipation and loss of appetite, abdominal enlargement and swelling of the legs, abdomen striae are excessive expansion of the skin and visible veins resembling the mythical Medusa’s head as a result of collateral circulation. Portal hypertension leads to the development of collateral circulation, enlarged spleen, kidney failure. Liver failure also predispose to a higher incidence of hepatocellular carcinoma is an increased risk of infections, especially lung.They are important metabolic complications – failure of processing of fats, carbohydrates and proteins. Last but not least, reduce hassles and rebuilding the liver.

Other names: hepatic coma, hepatic encephalopathy

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