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Liver enzyme estimation in Liver trauma and other querries.

ken kmattox1 at mycingular.blackberry.net
Sat Apr 15 15:49:40 BST 2006


No. For isolated liver trauma.   Do not give antibiotics and do not order post op liver function tests unless you ligated the hepatic artery and gave hepatotoxic drugs.  Then measure the IQ of the surgeon. 

K


Sent via BlackBerry, return via KMattox at aol.com


-----Original Message-----
From: "Roy Danks" <roydanks at hotmail.com>
Date: Sat, 15 Apr 2006 09:28:25 
To:"Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
Subject: RE: Re: Liver enzyme estimation in Liver trauma and other querries.

The only surgeons I know who follow liver enzymes in blunt liver trauma are some peds surgeons.  I don't know why and I never saw the value in them.  Of course, I've not taken the time to review the literature.

Antibiotics?  Not to my knowledge, though we had a young lady with a grade 5 injury with bile and blood in the belly and we did a 48 hr course at the behest of the liver transplant surgeon who was consulted.  She subsequently did well.  There: there's some class X evidence.  Ha.

I will tell you that I have not routinely followed liver enzymes in my blunt liver patients.

The guy to quiz is Donald Trunkey at Oregon.  He's kind of the U.S. liver trauma guru.  

Regards,

RD
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