Microdialysis in the management of hepatic encephalopathy.
BACKGROUND
Fulminant hepatic encephalopathy has a high mortality.


METHODS
This case report describes the role of cerebral microdialysis as an adjunct to the management of a 49 - year-old woman with hepatic encephalopathy secondary to a paracetamol overdose.


RESULTS
The application of the microdialysis technique, by detecting a very low cerebral glucose concentration in the presence of a normal plasma glucose, assisted in clinical decision making.


CONCLUSIONS
Cerebral microdialysis, by enabling continuous on-line monitoring of substrate delivery and metabolism, may have a role in the management of patients with fulminant hepatic failure.
Hutchinson
P J
PJ
Academic Department of Neurosurgery, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK. pjah2@cam.ac.uk
Gimson
A
A
Al-Rawi
P G
PG
O'Connell
M T
MT
Czosnyka
M
M
Menon
D K
DK
D000082:Acetaminophen / Q000506:poisoning; D018712:Analgesics, Non-Narcotic / Q000506:poisoning; D001786:Blood Glucose / Q000378:metabolism; D001921:Brain / Q000503:physiopathology*; D001929:Brain Edema / Q000139:chemically induced / Q000503:physiopathology* / Q000628:therapy; D003422:Critical Care; D011431:Dextropropoxyphene / Q000506:poisoning; D004338:Drug Combinations; D004347:Drug Interactions; D045604:Extracellular Fluid / Q000502:physiology*; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D005947:Glucose / Q000008:administration & dosage*; D006501:Hepatic Encephalopathy / Q000139:chemically induced / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D007427:Intracranial Pressure / Q000187:drug effects / Q000502:physiology; D019344:Lactic Acid / Q000378:metabolism; D017114:Liver Failure, Acute / Q000139:chemically induced / Q000503:physiopathology* / Q000628:therapy; D017551:Microdialysis; D008875:Middle Aged; D019289:Pyruvic Acid / Q000378:metabolism; D018967:Risperidone / Q000506:poisoning
D018712:Analgesics, Non-Narcotic; D001786:Blood Glucose; D004338:Drug Combinations; D019344:Lactic Acid; D000082:Acetaminophen; C011800:acetaminophen, dextropropoxyphene, drug combination; D019289:Pyruvic Acid; D005947:Glucose; D018967:Risperidone; D011431:Dextropropoxyphene