Hepatic regulation of systemic inflammation following acute injury

Systemic inflammation contributes to multiple organ dysfunction, which remains a common pathway of intensive care unit morbidity. Organ interactions, with the liver providing a central regulatory role, appear to be a contributing mechanism for sustained systemic inflammation. Key overlapping mechanisms by which the liver regulates inflammation include its production of predominantly anti-inflammatory acute-phase proteins, Kupffer cell production of cytokines, and hepatocellular clearance of circulating mediators and endotoxin. Interventions directed at assessing these hepatic functions and therapies directed at supporting them should improve outcomes for intensive care unit patients in the reversible stages of multiple organ dysfunction syndrome.