Insertion of intracranial pressure monitors in fulminant hepatic failure patients: early experience using recombinant factor VII.
Neurosurgery
; 66(3): 455-8; discussion 458, 2010 Mar.
Article
em En
| MEDLINE
| ID: mdl-20173540
ABSTRACT
BACKGROUND:
Cerebral edema contributes to the high morbidity and mortality of fulminant hepatic failure (FHF).OBJECTIVE:
We report the results of our early experience with insertion of intraparenchymal intracranial pressure (ICP) monitors in these highly coagulopathic patients.METHODS:
Eleven consecutive patients with FHF met the criteria for invasive ICP monitoring. Recombinant activated factor VII (rFVIIa) was administered at an average dose of 3 mg intravenous bolus (average, 36.7 microg/kg). We inserted the intraparenchymal ICP monitor within 15 minutes to 2 hours after rFVIIa administration, without waiting for the repeat coagulation results. Postprocedure computed tomographic scans of the brain were obtained in all patients.RESULTS:
No hemorrhagic complications were detected on the immediate postprocedure computed tomographic scans. There were no thrombotic complications in this group of patients.CONCLUSION:
In this group of patients with FHF, placement of an ICP monitor without hemorrhagic or thrombotic complications was feasible after administration of rFVIIa. This is a report of our early experience, and caution is advised. Further collaborative randomized studies are needed to prove the efficacy, optimal dosing, and cost effectiveness of rFVIIa for the placement of ICP monitors in this group of patients.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hemostáticos
/
Pressão Intracraniana
/
Fator VIIa
/
Falência Hepática Aguda
Tipo de estudo:
Observational_studies
Limite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Neurosurgery
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Estados Unidos