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Vol. 53, No. 2, 1989
Issue release date: 1989
Section title: Original Paper
Nephron 1989;53:142–146
(DOI:10.1159/000185727)

Changes in Intracranial Pressure during Haemofiltration in Oliguric Patients with Grade IV Hepatic Encephalopathy

Davenport A.a · Will E.J.a · Davison A.M.a · Swindells S.b · Cohen A.T.b · Miloszewski K.J.A.c · Losowsky M.S.c
Department of aRenal Medicine, bIntensive Care Units, and cDepartment of Medicine, St. James’s University Hospital, Leeds, UK

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Accepted: 1/20/1989
Published online: 12/10/2008
Issue release date: 1989

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 0

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: http://www.karger.com/NEF

Abstract

Seven consecutive patients with grade IV hepatic encephalopathy, due to fulminant hepatic failure complicated by oliguric renal failure were allocated at random to treatment with daily machine haemofiltration (MHF) or continuous arteriovenous haemofiltration (CAVHF). Intracranial pressure (ICP) was continuously monitored using a subdural catheter. Four patients received 17 treatments by MHF, and ICP increased from 8.4 ± 1.5 mm Hg (mean + SEM) prior to treatment to 12.6 ± 1.8 mm Hg on completion (p < 0.05). Active intervention was required on twenty occasions to treat sustained increases in ICP (greater than 25 mm Hg maintained for 5 min or longer). A total of 12 haemofilters were used in the treatment of 3 patients by CAVHF. The ICP showed greater stability during CAVHF therapy, the mean pressure prior to treatment was 15.6 ± 5.2 mm Hg and fell to 11.7 + 2.3 mm Hg at 4 h. Sustained increases in ICP occurred in only 1 patient as a preterminal event. These findings suggest that CAVHF is the preferred method of treatment in patients with fulminant hepatic failure complicated by oliguric renal failure who are at risk of developing cerebral oedema.

© 1989 S. Karger AG, Basel


  

Author Contacts

Dr. A. Davenport, Department of Renal Medicine, St. James’s University Hospital, Beckett Street, Leeds LS9 7TF (UK)

  

Article Information

Accepted: January 20, 1989
Published online: December 10, 2008
Number of Print Pages : 5

  

Publication Details

Nephron

Vol. 53, No. 2, Year 1989 (Cover Date: 1989)

Journal Editor: Fine L.G. (Los Angeles, Calif.)
ISSN: 0028-2766 (Print), eISSN: 1423-0186 (Online)

For additional information: http://www.karger.com/NEF


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Accepted: 1/20/1989
Published online: 12/10/2008
Issue release date: 1989

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 0

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: http://www.karger.com/NEF


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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