Moderate hypothermia prevents cerebral hyperemia and increase in intracranial pressure in patients undergoing liver transplantation for acute liver failure

@article{Jalan2003ModerateHP,
  title={Moderate hypothermia prevents cerebral hyperemia and increase in intracranial pressure in patients undergoing liver transplantation for acute liver failure},
  author={Rajiv Jalan and Steven W. M. Olde Damink and Nicolaas E. P. Deutz and Nathan A. Davies and Oliver J Garden and Krishnakumar Madhavan and Peter C Hayes and Alistair Lee},
  journal={Transplantation},
  year={2003},
  volume={75},
  pages={2034-2039}
}
Background. During orthotopic liver transplantation (OLT) for acute liver failure (ALF), some patients develop acute increases in intracranial pressure (ICP). The authors tested the hypothesis that increases in ICP during OLT for ALF can be prevented by moderate hypothermia. Methods. Sixteen patients with ALF undergoing OLT were studied. Depending on the measured ICP before OLT, the patients were divided into three groups as follows: group I (n=6), did not require treatment for increased ICP… 
Moderate hypothermia in patients with acute liver failure and uncontrolled intracranial hypertension.
TLDR
Moderate hypothermia is an effective and safe bridge to OLT in patients with ALF who have increased ICP that is resistant to standard medical therapy and a large multicenter trial of hypthermia in ALF is justified.
Hypothermia for the Management of Intracranial Hypertension in Acute Liver Failure
TLDR
Data from studies in patients undergoing liver transplantation for ALF suggest that increases in intracranial pressure can be prevented during the dissection and reperfusion phases of the operation if the patients are maintained hypothermic during surgery.
Hypothermia for the management of intracranial hypertension in acute liver failure
TLDR
Moderate hypothermia is a safe and effective method of treatment for increased intracranial pressure that is unresponsive to other medical therapies, and that this treatment can be used as a successful bridge to liver transplantation.
Intracranial hypertension in acute liver failure: pathophysiological basis of rational management.
  • R. Jalan
  • Medicine
    Seminars in liver disease
  • 2003
TLDR
Advances in understanding the pathophysiological basis of intracranial hypertension in ALF have outstripped appropriate testing of the newly generated ideas in appropriate clinical trials, and more effort should be mounted at a national level to organize the appropriate multicenter studies required.
Therapeutic Hypothermia for Acute Liver Failure: Toward a Randomized, Controlled Trial in Patients with Advanced Hepatic Encephalopathy
TLDR
A randomized, controlled trial comparing the management of ALF patients under normothermic and hypothermic conditions is a logical extension of preliminary observations and considers the many difficulties which will be encountered in the design of such a trial in patients with ALF at high risk of developing cerebral edema.
Liver Failure and Intracerebral Hypertension
TLDR
There is an urgent need for new therapeutic approaches to the prevention of brain edema and increased ICP in ALF.
Therapeutic hypothermia for acute liver failure
TLDR
Although an ample body of experimental and human data provides a rationale for the use of therapeutic Hypothermia in patients with acute liver failure, multicenter, randomized, controlled clinical trials are needed to confirm that hypothermia secures brain viability and improves survival without causing harm.
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