Similarly, the presence of hypoxic hepatitis-defined as the presence of a transient increase in serum aminotransferase activity of over 20 times the upper limit of the normal range in the absence of putative causes of liver necrosis (virus, drugs)-in patients with cardiocirculatory or respiratory failure was carefully scrutinised in a large cohort of 1,066 patients admitted to a medical ICU [21] . The mortality of the 118 patients who fulfilled the criteria of hypoxic hepatitis was indeed increased, especially in the subgroup of patients who required vasopressor therapy. After adjustment, the presence of hypoxic hepatitis was found to be a strong independent risk factor for mortality in patients receiving vasopressor therapy.