Related Experiment Video
Updated: Jul 3, 2026

Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen
Published on: November 27, 2019
Results of a protocol for the management of patients with fulminant liver failure
Robert A Raschke1, Steven C Curry, Silke Rempe
1Banner Good Samaritan Medical Center, Phoenix, AZ, USA. Robert.Raschke@bannerhealth.com
Objective:
To assess the safety and efficacy of a protocol to support management of intracerebral pressure in patients with fulminant liver failure (FLF).
Design And Setting:
A prospective series was conducted between May 2004 and September 2006 at Banner Good Samaritan Medical Center, a 650-bed teaching hospital in Phoenix, Arizona.
Patients:
We recruited consecutive patients with FLF and stage 3 or 4 encephalopathy.
Interventions:
We placed an intracranial pressure monitor in each patient and employed a protocol to support decisions regarding hemostatic management and prevention and treatment of intracranial hypertension (IHTN). Treatment modalities included hypothermia, hypocarbia, intravenous pentobarbital, intravenous mannitol and vasopressor titration for maintenance of cerebral perfusion pressure. The main outcome measure was survival in transplant candidates.
Measurements And Main Results:
Twenty-two patients entered the study and 21 (95%) had at least one episode of IHTN. Eighty-two discrete episodes of IHTN occurred, and 78 of these (95%) resolved with treatment. Overall survival was 55%. Eleven of 18 (61%) of transplant candidates survived with good neurologic outcome. No patient died from isolated cerebral edema. Three patients had intracranial hemorrhages related to the intracranial pressure monitor.
Conclusions:
Protocol-driven management of intracranial pressure in FLF can result in good clinical outcomes in most transplant candidates, even if IHTN occurs.
More Related Videos
Related Concept Videos
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...

