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Cardiovascular complications

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A common complication of acute hepatic failure is a reduction in peripheral resistance which requires a reflex increase in cardiac output to maintain blood pressure. Cardiac failure and hypotension may result if there is pre-existing heart disease.

The nature of the microvascular dysfunction is such that blood is shunted away from actively respiring tissues so that:

  • the oxygen extraction ratio decreases
  • lactic acid levels increase

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