- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Section 6 The gastrointestinal system
- Part 6.1 Physiology
- Part 6.2 Gastrointestinal monitoring
- Part 6.3 Gastrointestinal haemorrhage
- Part 6.4 Disordered gastric motility
- Part 6.5 The acute abdomen in the ICU
- Part 6.6 Pancreatitis
- Part 6.7 Jaundice
- Chapter 192 Pathophysiology and causes of jaundice in the critically ill
- Chapter 193 Management of jaundice in the critically ill
- Part 6.8 Acute hepatic failure
- Part 6.9 Acute on chronic hepatic failure
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care
Pathophysiology and causes of jaundice in the critically ill
- Chapter:
- Pathophysiology and causes of jaundice in the critically ill
- Author(s):
Anand D. Padmakumar
and Mark C. Bellamy
- DOI:
- 10.1093/med/9780199600830.003.0192
Critically-ill patients develop jaundice for a variety of reasons. A good understanding of bilirubin metabolism can help the clinician to diagnose and treat jaundice. Intensive care unit (ICU) physicians commonly encounter elevated serum bilirubin in severely-ill patients, which can be associated with increased morbidity and mortality. A complex interaction of enzymatic pathways leads to safe excretion of bilirubin. This fine homeostasis is often disturbed and leads jaundice, which can be broadly classified into three main categories—prehepatic, hepatic, and post-hepatic. Common examples include sepsis, cardiac failure, drug toxicity, hepatic ischaemia, gall stone disease, etc. Management strategies directed towards the underlying causes aim to improve outcome. The aetiology can be often multifactorial and difficult to treat. This chapter provides a brief overview of bilirubin metabolism and aetiopathogenesis of jaundice. We also provide key recommendations to develop a systematic diagnostic approach, provide guidance on ordering appropriate investigations and on interpreting their results.
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- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Section 6 The gastrointestinal system
- Part 6.1 Physiology
- Part 6.2 Gastrointestinal monitoring
- Part 6.3 Gastrointestinal haemorrhage
- Part 6.4 Disordered gastric motility
- Part 6.5 The acute abdomen in the ICU
- Part 6.6 Pancreatitis
- Part 6.7 Jaundice
- Chapter 192 Pathophysiology and causes of jaundice in the critically ill
- Chapter 193 Management of jaundice in the critically ill
- Part 6.8 Acute hepatic failure
- Part 6.9 Acute on chronic hepatic failure
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care