1. Factors associated with severe intracranial hypertension in candidates for emergency liver transplantation
- Author
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Michael J. Moritz, Paul Martin, J. S. Radomski, Rodney Bell, Bruce E. Northrup, and Santiago J. Munoz
- Subjects
Adult ,Male ,medicine.medical_specialty ,Fever ,Intracranial Pressure ,medicine.medical_treatment ,Encephalopathy ,macromolecular substances ,Liver transplantation ,Cerebral edema ,Fulminant hepatic failure ,Ammonia ,Internal medicine ,medicine ,Humans ,In patient ,Contraindication ,Psychomotor Agitation ,Cause of death ,Transplantation ,Pseudotumor Cerebri ,business.industry ,Contraindications ,Factor V ,Alanine Transaminase ,Bilirubin ,medicine.disease ,Surgery ,Liver Transplantation ,surgical procedures, operative ,Brain Injuries ,Hepatic Encephalopathy ,Hypertension ,Cardiology ,Prothrombin Time ,Female ,alpha-Fetoproteins ,business - Abstract
Cerebral edema is the leading cause of death in patients with fulminant hepatic failure (FHF). Emergency OLT is often a life-saving therapy for FHF but severe cerebral edema is a contraindication to transplantation. We attempted to identify clinical and biochemical factors associated with the development of severe intracranial hypertension in FHF. Fever, psychomotor agitation, and arterial hypertension were more frequently observed preceding episodes of severe intracranial hypertension, and more than 50% of FHF patients with uncontrolled intracranial hypertension sustained severe brain injury in our series. These observations suggest that vigorous treatment of fever, arterial hypertension, and agitation are important aspects of the intensive care management of FHF patients to maintain their OLT candidacy.
- Published
- 1993