• Arq Neuropsiquiatr · Jun 2008

    Intraparenchymal intracranial pressure monitoring in patients with acute liver failure.

    • Alejandra T Rabadán, Natalia Spaho, Diego Hernández, Adrián Gadano, and Eduardo de Santibañes.
    • Unidad de Transplante Hepático, Servicio de Neurocirugía, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
    • Arq Neuropsiquiatr. 2008 Jun 1;66(2B):374-7.

    BackgroundElevated 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.MethodTwenty-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.ResultsEleven 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.ConclusionIn 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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