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Prevention and management of brain edema in patients with acute liver failure
Author(s) -
Larsen Fin Stolze,
Wendon Julia
Publication year - 2008
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21643
Subject(s) - medicine , intracranial pressure , cerebrospinal fluid , hypothermia , anesthesia , cerebral edema , edema , blood pressure , brain edema , cerebral blood flow
Key Points1 Intracranial pressure is the pressure exerted by the cranial contents on the dural envelope and consists of the partial pressures of the brain, blood, and cerebrospinal fluid. 2 Severe cases of acute liver failure are frequently complicated by brain edema (due to cytotoxic edema) and an increase in cerebral blood flow while the cerebrospinal fluid volume remains constant. 3 The development of intracranial hypertension in patients with acute liver failure may be controlled by manipulation of the position, body temperature, plasma tonicity, arterial carbon dioxide tension, and arterial pressure. 4 If intracranial hypertension evolves despite these first‐tier interventions, increased sedation, induction of hypothermia (body temperature of 33°C to 34°C), and the use of anti‐inflammatory drugs may help secure brain viability.Liver Transpl 14:S90–S96, 2008. © 2008 AASLD.