Intracranial pressure monitoring in the perioperative period of patients with acute liver failure undergoing orthotopic liver transplantation

• Published in: World journal of transplantation Vol. 13; no. 4; pp. 122 - 128
• Main Authors: Mendoza Vasquez, Luis Eduardo, Payne, Sonja, Zamper, Raffael
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 18.06.2023
• Subjects: Minireviews; Liver transplant; Acute liver failure; Brain edema; Intracranial hypertension; Hepatic encephalopathy
• ISSN: 2220-3230; 2220-3230
• DOI: 10.5500/wjt.v13.i4.122

Acute liver failure (ALF) may result in severe neurological complications caused by cerebral edema and elevated intracranial pressure (ICP). Multiple pathogenic mechanisms explain the elevated ICP, and newer hypotheses have been descri bed. While invasive ICP monitoring (ICPM) may have a role in ALF management, these patients are typically coagulopathic and at risk for intracranial hemorrhage. ICPM is the subject of much debate, and significant heterogeneity exists in clinical practice regarding its use. Contemporary ICPM techniques and coagulopathy reversal strategies may be associated with a lower risk of hemor rhage; however, most of the evidence is limited by its retrospective nature and relatively small sample size.