Intraparenchymal intracranial pressure monitoring in patients with acute liver failure

Arquivos de Neuro-Psiquiatria

Alejandra T. Rabadán¹  Natalia Spaho¹  Diego Hernández¹  Adrián Gadano¹  Eduardo De Santibañes¹ 

[1] ,Hospital Italiano de Buenos Aires Servicio de Neurocirugía Unidad de Transplante HepáticoBuenos Aires,Argentina

关键词: fulminant hepatic failure;    hemorrhagic complications;    intracranial pressure monitoring;    falla hepática fulminante;    complicaciones hemorrrágicas;    monitoreo de presión intracraneana;   

DOI  :  10.1590/S0004-282X2008000300018

来源: SciELO

【 摘 要 】

BACKGROUND: Elevated intracranial pressure (ICP) is a common cause of death in acute liver failure (ALF) and is determinant for decision-making regarding the timing of liver transplantation. The recommended type ICP monitoring device is controversial in ALF patients. Epidural devices had less risk of hemorrhagic complications, but they are less reliable than intraparenchymal ones. METHOD: Twenty-three patients with ALF were treated, and 19 of them received a liver transplant. Seventeen patients had ICP monitoring because of grade III-IV encephalopathy. All patients received fresh plasma (2-3 units) before and during placing the intraparenchymal device. RESULTS: Eleven cases (64.7%) had elevated ICP, and 6 patients (35.2%) had normal values. One patient (5.9%) had an asymptomatic small intraparenchymal haemorrhage <1cm³ in CTscan, which did not prevent the liver transplantation. CONCLUSION: In our experience, intraparenchymal ICP monitoring in patients with ALF seems to be an accurate method with a low risk of complications.

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