Nephrol Dial Transplant (2002) 17: 23-27
© 2002 European Renal Association-European Dialysis and Transplant Association
Invited Comment
Intracranial hypertension in acute liver failure
1 Department of Nephrology, York District Hospital, York and 2 Department of Anaesthesia, St James University Hospital, Leeds, UK
Keywords: continuous renal replacement therapy; hepatic encephalopathy; hepatic failure; hypertonic mannitol; intensive care; intracranial hypertension; renal failure
Introduction
The development of liver failure is a medical emergency requiring specialist assessment and care. The development of renal failure in the patient with hepatic failure is one of the few prognostic indicators of poor outcome. Its presence is associated with prolonged intensive care unit (ICU) stay, prolonged hospitalization and death [1,2]. The high incidence of renal failure with necessity for dialysis support requires the nephrologist to have an understanding of liver failure and its concomitant complications. Indeed the nephrologist may be called upon outside of a liver centre to provide advice and may be in a position to guide subsequent management and referral to an appropriate centre or within that centre may be asked to assist with investigation and management. An understanding of the causes and treatments of intracranial hypertension will better arm the nephrologist in the management of this syndrome.
Encephalopathy and intracranial hypertension: not the same thing
Encephalopathy is characterized by decreased
Hepatic syndromes: the relationship with renal failure and intracranial hypertension
Aetiology of intracranial hypertension
Management of hepatic failure
Intracranial hypertension
Definition
Monitoring
Management
Conclusion
The future
The present
Notes
References