Neurological Monitoring in Acute Liver Failure.
Hepatology. 2019 May 11;:
Authors: Reynolds AS, Brush B, Schiano TD, Reilly KJ, Dangayach NS
Acute liver failure (ALF) results in diffuse cerebral dysfunction ranging from minor hepatic encephalopathy (HE) to coma, and disproportionately affects young, healthy adults. In these patients, neurological morbidity and mortality results from the development of cerebral edema and elevated intracranial pressure (ICP).(1) HE is potentially reversible with timely liver transplantation or spontaneous improvement in liver dysfunction, and prompt treatment of these patients can prevent death and improve outcomes. No single method can effectively identify patients at risk for cerebral edema. A high ammonia level should raise suspicion but on its own is not sufficient.(2) Monitoring of ALF patients for the development of cerebral edema and elevated ICP is fundamental to prevent death and improve outcomes. This review aims to discuss the benefits and drawbacks of monitoring modalities and propose a monitoring protocol. This article is protected by copyright. All rights reserved.
PMID: 31077591 [PubMed - as supplied by publisher]