Cholestatic liver dysfunction in critically ill children: A boon or a bane?

The phenomenon of “intensive care unit (ICU) jaundice” describes cholestasis that occurs in critically ill patients. This ICU jaundice occurs in 20% of critically ill subjects, as a result of non-obstructive intrahepatic disruptions. Despite its common occurrence, not many studies have ex-plored the clinical significance behind this phe-nomenon. Cholestasis in the critically ill has been associated with a grim prognosis, reflected by . serum bilirubin value in many prognostic mark-ers. Not until recently, researchers have shed some light on this phenomenon, not as a mere clinical manifestation of organ dysfunction, but with a protective role in critical illness. This review highlights the physiology and pathophysiol-ogy behind cholestatic liver dysfunction in critically ill children, its possible benefit, and its harm, as well as factors affecting its severity.