Intracranial pressure observations in a canine model of acute liver failure supported by a bioartificial liver support system.
Life-threatening, severely elevated intracranial pressure (ICP) is a common feature of acute liver failure (ALF). Perfusion with a bioartificial liver may serve to mitigate rising ICP. A retrospective analysis of ICP measurements in a canine ALF model prospectively supported with a bioartificial liver support system (BLSS) is presented. Animals are divided into two groups based upon care provided: (i) standard medical care (n = 6); and (ii) standard medical care plus BLSS support (n = 9). Nonparametric analysis with respect to ICP, arterial NH(3), lactate, and supportive-care parameters found BLSS-supported animals evidenced significantly less metabolic acidosis than unsupported animals. Analysis of variance/linear regression for direct dependence of ICP on arterial NH(3), lactate, and supportive care parameters irrespective of care found ICP was uncorrelated with any measured factor (P > 0.06 for all factors). Lack of correlation of ICP with the considered parameters indicates that none of these factors are predictive of the extent of ICP elevation in the D-galactosamine canine model. Blood chemistry and supportive care factors that are correlated with and predictive of ICP elevation remain to be identified.
Patzer
John F
JF
Department of Surgery; Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA 15261, USA. patzer@pitt.edu
Lopez
Roberto C
RC
Aggarwal
Shushma
S
D000818:Animals; D004195:Disease Models, Animal; D004285:Dogs; D005688:Galactosamine; D019586:Intracranial Hypertension / Q000209:etiology / Q000517:prevention & control*; D007427:Intracranial Pressure; D017114:Liver Failure, Acute / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D019164:Liver, Artificial; D011336:Probability; D011897:Random Allocation; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D015996:Survival Rate
D005688:Galactosamine