Lipofundin-induced intracranial pressure rise after severe traumatic brain injury--a case report.
Early nutrition is a recognized component of neurosurgical intensive care treatment. The authors present the case of a patient suffering from severe traumatic brain injury who responded with reproducible intracranial pressure (ICP) crisis to infusion of Lipofundin, a fatty soybean oil-based emulsion for parenteral nutrition. During the described ICP rise, the patient remained hemodynamically stable, therefore an anaphylactic reaction seems to be unlikely. An increase of brain tissue oxygenation parallel to the ICP rise in this case is suggestive for increased cerebral blood flow as a cause of ICP elevation after application of Lipofundin. Without multimodal monitoring and data storage, the described side effect of Lipofundin in our patient would have been difficult to identify.
Wolf
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S
Department of Neurosurgery, Academic Hospital Munich-Bogenhausen, Technical University of Munich, Munich. stefanwolf@operamial.com
Krammer
M
M
Trost
H A
HA
Lumenta
C B
CB
D000058:Accidental Falls; D000328:Adult; D001930:Brain Injuries / Q000503:physiopathology*; D004338:Drug Combinations; D005217:Fat Emulsions, Intravenous / Q000009:adverse effects*; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000139:chemically induced*; D010743:Phospholipids / Q000009:adverse effects*; D013012:Sorbitol / Q000009:adverse effects*
D004338:Drug Combinations; D005217:Fat Emulsions, Intravenous; D010743:Phospholipids; C008288:Lipofundin; D013012:Sorbitol