Clinical Course of Abnormalities in the Liver Function of Patients Resuscitated after Cardiac Arrest

ABSTRACT

PURPOSE: Little is known about the clinical courses or outcomes of abnormalities of liver function in patients resuscitated after cardiac arrest. We conducted this study to investigate the clinical features and courses of abnormalities of liver function during the post-resuscitation period. METHODS: Twenty-five patients (18 males, mean age: 43 years), who had survived cardiac arrest, were enrolled in this study. Blood samples for the liver function test were obtained immediately and at 1, 2, 4, 7, 10, and 14 days after return of spontaneous circulation. Clinical characteristics, variables associated with cardiac arrest, data during resuscitation, and clinical course during the post-resuscitation period were obtained from our cardiac arrest database. RESULTS: Seventeen patients (68%) had abnormalities of liver function. Those abnormalities included, in order of frequency, increases in aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (gamma-GT), or total bilirubin in blood, and a decrease in serum albumin. The highest values of AST, ALT, gamma-GT, and total bilirubin were observed on the second day of postresuscitation period. The abnormalities were normalized in all patients within two weeks after the cardiac arrest. There was no deaths from hepatic failure. There was no difference in downtime, CPR time, number of defibrillations, dose of administered epinephrine, blood pressure, or heart rate after return of spontaneous circulation between the patients with normal liver function and the patients with abnormal liver function (increase of AST or ALT > 50 U/L). Multiple logistic regression analysis revealed that the duration of cardiac arrest was associated with the elevation of liver enzymes. CONCLUSION: Hepatic dysfunction after cardiac arrest is a transient, benign phenomenon. Development of hepatic dysfunction was associated with the duration of cardiacarrest.