Microdialysis in the management of hepatic encephalopathy

Neurocrit Care. 2006;5(3):202-5. doi: 10.1385/NCC:5:3:202.

Abstract

Introduction: Fulminant hepatic encephalopathy has a high mortality.

Methods: This case report describes the role of cerebral microdialysis as an adjunct to the management of a 49 - year-old woman with hepatic encephalopathy secondary to a paracetamol overdose.

Results: The application of the microdialysis technique, by detecting a very low cerebral glucose concentration in the presence of a normal plasma glucose, assisted in clinical decision making.

Conclusions: Cerebral microdialysis, by enabling continuous on-line monitoring of substrate delivery and metabolism, may have a role in the management of patients with fulminant hepatic failure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetaminophen / poisoning
  • Analgesics, Non-Narcotic / poisoning
  • Blood Glucose / metabolism
  • Brain / physiopathology*
  • Brain Edema / chemically induced
  • Brain Edema / physiopathology*
  • Brain Edema / therapy
  • Critical Care*
  • Dextropropoxyphene / poisoning
  • Drug Combinations
  • Drug Interactions
  • Extracellular Fluid / physiology*
  • Female
  • Frontal Lobe / physiopathology
  • Glucose / administration & dosage*
  • Hepatic Encephalopathy / chemically induced
  • Hepatic Encephalopathy / physiopathology*
  • Hepatic Encephalopathy / therapy
  • Humans
  • Intracranial Pressure / drug effects
  • Intracranial Pressure / physiology
  • Lactic Acid / metabolism
  • Liver Failure, Acute / chemically induced
  • Liver Failure, Acute / physiopathology*
  • Liver Failure, Acute / therapy
  • Microdialysis*
  • Middle Aged
  • Pyruvic Acid / metabolism
  • Risperidone / poisoning

Substances

  • Analgesics, Non-Narcotic
  • Blood Glucose
  • Drug Combinations
  • Lactic Acid
  • Acetaminophen
  • acetaminophen, dextropropoxyphene, drug combination
  • Pyruvic Acid
  • Glucose
  • Risperidone
  • Dextropropoxyphene