Liver failure and drug metabolism.

The hepatic microsomal metabolism of antipyrine, as measured by its metabolic clearance, was investigated in 18 patients either before, during, or after hepatic encephalopathy. The antipyrine clearance measured in 13 patients during hepatic encephalopathy (4.6 ml/min. S.D. 14) was significantly lower than that of 5 patients investigated 4 weeks before or after hepatic encephalopathy (9.6 ml/min. S.D. 1.9). The clearance of antipyrine as a measure of a quantitative liver function is substantiated by the present observations, and its use as a prognostic indicator of acute liver failure is suggested.