{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:42:41Z","timestamp":1787071361768,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:p>Hypoxic hepatitis (HH) is characterized by marked and transient elevations in liver enzyme levels in the absence of other potential causes of liver injury. Although rare, it can occur in the presence of hemodynamic instability and hypoxemia in patients with cor pulmonale. We report two cases of perioperative HH in patients with severe pulmonary disease and cor pulmonale. The first case is of a patient with cor pulmonale who underwent hemiarthroplasty for a femur fracture. Transient hypotension developed during spinal anesthesia and severe hypoxemia were observed in the postoperative period. After surgery, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels suddenly increased to 3740 and 817 U\/L, respectively. The second case is of a patient with congestive heart failure and cor pulmonale whose blood pressure and oxygen saturation decreased during induction of general anesthesia and after surgery, and AST, ALT, and lactic dehydrogenase levels increased to 1291, 1292, and 2710 U\/L, respectively. The liver enzyme levels normalized within 7\u201314 days in both cases. We speculate the diagnosis of these cases as HH.<\/jats:p>","DOI":"10.4103\/1658-354x.209167","type":"journal-article","created":{"date-parts":[[2017,6,29]],"date-time":"2017-06-29T11:05:45Z","timestamp":1498734345000},"page":"335-339","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Hypoxic hepatitis during the perioperative period in patients with severe pulmonary disease and cor pulmonale"],"prefix":"10.4103","volume":"11","author":[{"given":"Hyuckgoo","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Pusan National University Yangsan Hospital, Nam-gu, Daegu, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Jin","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Nam-gu, Daegu, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deokhee","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Nam-gu, Daegu, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250926","first-page":"192","article-title":"Surgery in the patient with liver disease","volume":"121","author":"Friedman","year":"2010","journal-title":"Trans Am Clin Climatol Assoc"},{"key":"R2-20250926","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1111\/j.1478-3231.2011.02655.x","article-title":"Hypoxic hepatitis","volume":"32","author":"Henrion","year":"2012","journal-title":"Liver Int"},{"key":"R3-20250926","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1007\/s12072-011-9336-1","article-title":"Hypoxic hepatitis: A challenging diagnosis","volume":"6","author":"Trilok","year":"2012","journal-title":"Hepatol Int"},{"key":"R4-20250926","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s00508-010-1357-6","article-title":"Hypoxic hepatitis \u2013 Epidemiology, pathophysiology and clinical management","volume":"122","author":"Fuhrmann","year":"2010","journal-title":"Wien Klin Wochenschr"},{"issue":"6 Suppl","key":"R5-20250926","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1097\/00000539-199512001-00005","article-title":"Biotransformation of sevoflurane","volume":"81","author":"Kharasch","year":"1995","journal-title":"Anesth Analg"},{"key":"R6-20250926","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1161\/01.RES.41.6.787","article-title":"Effects of acute, passive hepatic congestion on blood flow and oxygen uptake in the intact liver of the cat","volume":"41","author":"Lautt","year":"1977","journal-title":"Circ Res"},{"key":"R7-20250926","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1016\/S0022-3565(25)09644-2","article-title":"Right heart failure impairs hepatic oxygenation and theophylline clearance in rats","volume":"273","author":"Ng","year":"1995","journal-title":"J Pharmacol Exp Ther"},{"issue":"2 Suppl","key":"R8-20250926","doi-asserted-by":"crossref","first-page":"S44","DOI":"10.1097\/00003246-199302001-00009","article-title":"Tissue oxygenation in low flow states and during hypoxemia","volume":"21","author":"Grum","year":"1993","journal-title":"Crit Care Med"},{"key":"R9-20250926","doi-asserted-by":"crossref","first-page":"H860","DOI":"10.1152\/ajpheart.00384.2015","article-title":"Effects of milrinone and epinephrine or dopamine on biventricular function and hemodynamics in right heart failure after pulmonary regurgitation","volume":"309","author":"Hyldebrandt","year":"2015","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"R10-20250926","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.ccm.2015.05.015","article-title":"Management of right heart failure in the Intensive Care Unit","volume":"36","author":"Kholdani","year":"2015","journal-title":"Clin Chest Med"}],"container-title":["Saudi Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01437113-201711030-00015","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:44:56Z","timestamp":1787067896000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01437113-201711030-00015"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.4103\/1658-354x.209167","relation":{},"ISSN":["1658-354X","0975-3125"],"issn-type":[{"value":"1658-354X","type":"print"},{"value":"0975-3125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7]]}}}