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Related Experiment Videos

Changes in intracranial pressure during machine and continuous haemofiltration.

A Davenport1, E J Will, A M Davison

  • 1Department of Renal Medicine, St. James's University Hospital, Leeds, U.K.

The International Journal of Artificial Organs
|July 1, 1989
PubMed
Summary

Continuous arterio-venous haemofiltration (CAVHF) is preferred over machine haemofiltration (MHF) for patients with hepatorenal failure. CAVHF did not increase intracranial pressure (ICP), unlike MHF, which showed a significant ICP rise.

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Area of Science:

  • Nephrology
  • Hepatology
  • Intensive Care Medicine

Background:

  • Fulminant hepatic failure (FHF) and acute oliguric renal failure (AORF) present a critical clinical challenge.
  • Management of hepatorenal failure often requires renal replacement therapy.
  • Intracranial pressure (ICP) monitoring is crucial in critically ill patients with liver failure.

Purpose of the Study:

  • To compare the effects of machine haemofiltration (MHF) and continuous arterio-venous haemofiltration (CAVHF) on intracranial pressure (ICP) in patients with FHF and AORF.
  • To determine the optimal haemofiltration modality for managing acute hepatorenal failure.

Main Methods:

  • Nine consecutive patients with FHF and AORF were included.
  • Patients were treated with either MHF (n=6) or CAVHF (n=4).

Related Experiment Videos

  • Intracranial pressure (ICP) was monitored using a subdural catheter throughout the treatment duration (mean 56 hours).
  • Main Results:

    • MHF treatment led to a significant increase in mean ICP (8.9 to 14.8 mmHg, p<0.05).
    • CAVHF treatment did not show a significant increase in mean ICP (19.4 to 11.2 mmHg).
    • Eleven episodes of elevated ICP (>25 mmHg) occurred during MHF, requiring intervention, whereas none were recorded during CAVHF.

    Conclusions:

    • Continuous arterio-venous haemofiltration (CAVHF) is a safer and more effective modality than machine haemofiltration (MHF) for managing intracranial pressure in patients with acute hepatorenal failure.
    • CAVHF is recommended over MHF for patients experiencing both fulminant hepatic failure and acute oliguric renal failure.