Intracranial hypertension in acute liver failure: pathophysiological basis of rational management.

摘要: Increased intracranial pressure (ICP) in patients with acute liver failure (ALF) remains a major cause of morbidity and mortality. Conventional methods ammonia reduction such as the use lactulose do not improve outcome, metabolic substrates L-ornithine L aspartate may offer more promise. Mannitol mainstay therapy. An important role for cerebral hyperemia pathogenesis increased ICP has led to reevaluation established therapies hyperventilation, N-acetylcysteine, thiopentone sodium, propofol. Recent studies have focused on systemic inflammatory response support antibiotics prophylactically. Moderate hypothermia reduces uncontrolled hypertension prevents increases during orthotopic transplantation (OLT). Advances understanding pathophysiological basis ALF outstripped appropriate testing newly generated ideas clinical trials, effort should be mounted at national level organize multicenter required.