Intracranial pressure monitoring in patients with fulminant hepatic failure treated with plasma exchange and continuous hemodiafiltration.
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.
Nakanishi
Kazuya
K
Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Chiba University, Chuo, Japan. kaznaka@air.linkclub.or.jp
Hirasawa
Hiroyuki
H
Oda
Shigeto
S
Shiga
Hidetoshi
H
Matsuda
Kennichi
K
Nakamura
Masataka
M
Hirano
Takeshi
T
Hirayama
Yoh
Y
Moriguchi
Takeshi
T
Watanabe
Eizo
E
Nitta
Masakazu
M
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
D003102:Colloids; D002245:Carbon Dioxide