title: Intracranial pressure monitoring in patients with fulminant hepatic failure treated with plasma exchange and continuous hemodiafiltration.
abstract: OBJECTIVE
  To study the influence of our artificial liver support (ALS) on intracranial pressure (ICP) and to evaluate the significance of ICP monitoring in fulminant hepatic failure (FHF) patients treated with ALS.
  
  
  METHODS
  ICP was measured in 13 consecutive FHF patients treated with ALS. Maximum value in ICP every day was employed as ICPmax of the day. We analyzed the correlation: (a) between ICPmax and consciousness level; (b) between ICP and colloid osmotic pressure (COP), and (c) between ICP and PaCO2.
  
  
  RESULTS
  ICP in 11 patients of 13 was controlled < 20 mm Hg through our ALS. A significant positive correlation between ICPmax and consciousness level was found (p < 0.01). Although there was a significantly negative correlation between ICP and COP (p < 0.001), there was no correlation between ICP and PaCO2.
  
  
  CONCLUSIONS
  We conclude that our ALS does not have any adverse effects on ICP and that ICP monitoring is one of the inevitable monitorings in the management of FHF.
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Chiba University, Chuo, Japan. kaznaka@air.linkclub.or.jp
authors.forename: Kazuya
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hirasawa
authors.forename: Shigeto
authors.initials: S
authors.lastname: Oda
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Shiga
authors.forename: Kennichi
authors.initials: K
authors.lastname: Matsuda
authors.forename: Masataka
authors.initials: M
authors.lastname: Nakamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hirano
authors.forename: Yoh
authors.initials: Y
authors.lastname: Hirayama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Moriguchi
authors.forename: Eizo
authors.initials: E
authors.lastname: Watanabe
authors.forename: Masakazu
authors.initials: M
authors.lastname: Nitta
mesh_terms: D001794:Blood Pressure; D001795:Blood Pressure Determination; D001921:Brain / Q000098:blood supply*; D001930:Brain Injuries / Q000175:diagnosis / Q000517:prevention & control*; D002245:Carbon Dioxide / Q000097:blood; D003102:Colloids; D017583:Hemodiafiltration; D006801:Humans; D017114:Liver Failure, Acute / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D009997:Osmotic Pressure; D010951:Plasma Exchange; D014474:Unconsciousness
chemical_list: D003102:Colloids; D002245:Carbon Dioxide