Detection of liver xysfunction in severe burn injury with bedside measurement of perfusion
Background and Objectives: Severe burn injuries are still associated with high mortality. The length of intensive care stay is strongly influenced by the severity of organ failure, with multi-organ failure being the main cause of death in up to 40% of cases. Liver dysfunction is the second most comm...
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| Main Authors: | , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
28 February 2026
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| In: |
Medicina
Year: 2026, Volume: 62, Issue: 3, Pages: 1-14 |
| ISSN: | 1648-9144 |
| DOI: | 10.3390/medicina62030466 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.3390/medicina62030466 Verlag, kostenfrei, Volltext: https://www.mdpi.com/1648-9144/62/3/466 
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| Author Notes: | Marianne Kruse, András Varga, Berthold Hoppe, Alexander Hoenning, Martin Aman, Klaus Hahnenkamp, Marc Dominik Schmittner and Volker Gebhardt |
| Summary: | Background and Objectives: Severe burn injuries are still associated with high mortality. The length of intensive care stay is strongly influenced by the severity of organ failure, with multi-organ failure being the main cause of death in up to 40% of cases. Liver dysfunction is the second most common organ failure. Conventional diagnosis relies on static laboratory parameters that reflect damage already caused. Measuring the hepatic clearance of indocyanine green (LiMON®) offers a dynamic, bedside method for detecting liver dysfunction early, enabling timely therapy adjustments. Materials and Methods: In this prospective single-centre observational study, all patients admitted to the Unfallkrankenhaus Berlin Burns Centre from October 2022 to September 2024 with ≥30% TBSA burns were included. Liver function was assessed via LiMON® within 24 h post-injury and every 48 h until day 14 or ICU discharge. Static liver parameters were measured in parallel. Results: We included a total of 23 patients. An initial measurement was only successful in 18 cases. On admission, six patients (33%) had normal liver function with a plasma duration rate (PDR) > 18% (PDR 30.9 ± 7.3%), while 12 (67%) showed reduced clearance (PDR 14.5 ± 2.6%). In 75% of cases (n = 9), function recovered within 48 h. Based on PDR progression, four liver function patterns were defined: “stable”, “recovery”, “late insufficiency”, and “failure”; a fifth pattern included all patients who were deceased during this study (“death”). These groups differed in fluid therapy, plasma transfusion, and catecholamines administered. PDR correlated well with aminotransferase levels. Conclusions: Dynamic liver function monitoring enables earlier detection of impairment than static markers. Early identification of at-risk patients could guide fluid management and improve outcomes. LiMON® is a valuable tool in burn care, though alternative methods may be needed in patients with severe systemic hypoperfusion. |
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| Item Description: | Gesehen am 20.04.2026 |
| Physical Description: | Online Resource |
| ISSN: | 1648-9144 |
| DOI: | 10.3390/medicina62030466 |