Revista médica de Chile
versión impresa ISSN 0034-9887
CASTILLO F, Luis et al. Intravascular hypothermia for the management of Intracranial hypertension in acute liver failure: Case report. Rev. méd. Chile [online]. 2009, vol.137, n.6, pp. 801-806. ISSN 0034-9887. doi: 10.4067/S0034-98872009000600010.
Acute liver failure has a mortality rate in excess of 80%. Most deaths are attributed to brain edema with intracranial hypertension and herniation of structures, where ammonium plays a major role in its generation. We report an 18 year-old female with a fulminant hepatic failure caused by virus A infection. The patient developed a profound sopor and required mechanical ventilation. A CT scan showed the presence of brain edema and intracranial hypertension. A Raudemic® catheter was inserted to measure intracranial pressure and brain temperature. Intracranial hypertension became refractory and intravascular hypothermia was started, reducing brain temperature to 33°C. Seventy two hours later, a liver transplantation was performed. After testing graft perfusion, rewarming was started, completing 122 hours of hypothermia at 33°C. The patient was discharged in good conditions after 69 days of hospitalization.
Palabras clave : Brain edema; Hypothermia; Liver failure, acute.