scholarly journals Intensive Care Management of Patients with Acute Liver Failure with Emphasis on Systemic Hemodynamic Instability and Cerebral Edema: A Critical Appraisal of Pathophysiology

2000 ◽  
Vol 14 (suppl d) ◽  
pp. 105D-111D ◽  
Author(s):  
Fin Stolze Larsen ◽  
Bent Adel Hansen ◽  
Andres T Blei
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Cerebral Edema ◽  
Critical Appraisal ◽  
Hemodynamic Instability ◽  
Systemic Hemodynamic ◽  
New Treatments ◽  
The Brain

Acute liver failure (ALF) is a devastating disease leading to multiorgan dysfunction. The most dramatic impact of ALF is on the brain, as hepatic encephalopathy and intracranial hypertension (IH) develop. IH is associated with systemic hemodynamic instability, alterations in the regulation of cerebral blood flow and the development of cerebral edema. This review focuses on the pathophysiology of IH with special emphasis on cerebral blood flow and the development of cerebral edema. Based on these considerations, both traditional and new treatments for the management of IH in the future are discussed.

Cerebral Blood Flow in Acute Liver Failure: A Finding in Search of a Mechanism

2004 ◽  
Vol 19 (3/4) ◽  
pp. 177-194 ◽  
Author(s):  
Javier Vaquero ◽  
Chuhan Chung ◽  
Andres T. Blei
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Liver Failure ◽  
Acute Liver Failure

The brain in acute liver failure. A tortuous path from hyperammonemia to cerebral edema

2008 ◽  
Vol 24 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Peter Nissen Bjerring ◽  
Martin Eefsen ◽  
Bent Adel Hansen ◽  
Fin Stolze Larsen
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Cerebral Edema ◽  
The Brain

Hyperventilation restores cerebral blood flow autoregulation in patients with acute liver failure

1998 ◽  
Vol 28 (2) ◽  
pp. 199-203 ◽  
Author(s):  
Gitte Strauss ◽  
Bent Adel Hansen ◽  
Gitte Moos Knudsen ◽  
Fin Stolze Larsen
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Cerebral Blood Flow Autoregulation

Effect of Liver Failure on the Cerebral Circulatory and Metabolic Responses to Hypoxia in the Goat

1976 ◽  
Vol 50 (1) ◽  
pp. 15-23
Author(s):  
N. N. Stanley ◽  
N. S. Cherniack
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Liver Failure ◽  
Venous Blood ◽  
Practical Importance ◽  
Critical Threshold ◽  
Threshold Values ◽  
Arterial O2 Saturation ◽  
O2 Delivery ◽  
The Brain

1. Six unanaesthetized goats were used to evaluate the effect of liver failure on the hypoxic responsiveness of cerebral blood flow. The animals breathed air and several different hypoxic gas mixtures enriched with sufficient CO2 to maintain an isocapnic state. The cerebral metabolic rate for O2 (CMRo2) was also measured in four of these goats. 2. In baseline studies there was a linear relationship between cerebral blood flow and arterial O2 saturation (Sa,o2) measured at different levels of isocapnic hypoxia. The slopes of the cerebral blood flow/Sa,o2 response lines were used to quantify the response of cerebral blood flow to hypoxia. In the healthy goat, CMRo2 was not depressed by hypoxia until the O2 tension (Po2) in arterial and cerebral venous blood had fallen below critical threshold values of approximately 3·2 and 2·2 kPa (24 and 16 mmHg) respectively. 3. Liver failure was accompanied by a fall in cerebral blood flow and CMRo2. There was also a depression in the response of cerebral blood flow to hypoxia and a disproportionate reduction of cerebral O2 delivery in hypoxia. CMRo2 was further reduced at arterial and cerebral venous Po2 values, which were much higher than the critical threshold values for producing hypoxic CMRo2 depression in health. 4. It is concluded that the brain becomes more vulnerable to the adverse effects of hypoxia during liver failure. This may be of practical importance in the management of patients with arterial hypoxaemia or other complications (e.g. anaemia or shock), which may reduce cerebral oxygen delivery.

Pathogenesis of intracranial hypertension in acute liver failure: inflammation, ammonia and cerebral blood flow

2004 ◽  
Vol 41 (4) ◽  
pp. 613-620 ◽  
Author(s):  
Rajiv Jalan ◽  
Steven W.M. Olde Damink ◽  
Peter C. Hayes ◽  
Nicolaas E.P. Deutz ◽  
Alistair Lee
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Intracranial Hypertension

l-Arginine Improves the Diminished Cerebral Blood Flow in Rats With Acute Liver Failure: Uncertain Role of Asymmetric Dimethylarginine

2017 ◽  
Vol 7 ◽  
pp. S32-S33
Author(s):  
Anna Czarnecka ◽  
Krzysztof Jasinski ◽  
Radoslaw Jazwiec ◽  
Wojciech Hilgier ◽  
Anna Gajos-Draus ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Asymmetric Dimethylarginine

Vorläufige Ergebnisse von 99mTc-HMPAO-SPECT-Untersuchungen bei endogenen Psychosen

1989 ◽  
Vol 28 (03) ◽  
pp. 88-91
Author(s):  
J. Schröder ◽  
H. Henningsen ◽  
H. Sauer ◽  
P. Georgi ◽  
K.-R. Wilhelm
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Regional Cerebral Blood Flow ◽  
Regions Of Interest ◽  
Post Mortem ◽  
Regional Cerebral Blood ◽  
Hmpao Spect ◽  
Endogenous Psychoses ◽  
The Brain ◽  
99Mtc Hmpao

18 psychopharmacologically treated patients (7 schizophrenics, 5 schizoaffectives, 6 depressives) were studied using 99mTc-HMPAO-SPECT of the brain. The regional cerebral blood flow was measured in three transversal sections (infra-/supraventricular, ventricular) within 6 regions of interest (ROI) respectively (one frontal, one parietal and one occipital in each hemisphere). Corresponding ROIs of the same section in each hemisphere were compared. In the schizophrenics there was a significantly reduced perfusion in the left frontal region of the infraventricular and ventricular section (p < 0.02) compared with the data of the depressives. The schizoaffectives took an intermediate place. Since the patients were treated with psychopharmaca, the result must be interpreted cautiously. However, our findings seem to be in accordance with post-mortem-, CT- and PET-studies presented in the literature. Our results suggest that 99mTc-HMPAO-SPECT may be helpful in finding cerebral abnormalities in endogenous psychoses.

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