Effect of extracorporeal liver perfusion on the electroencephalogram of patients in coma due to acute liver failure
| Autor: | Sheila Sherlock, MacGillivray Bb, S. P. Parbhoo, Jean Kennedy |
|---|---|
| Rok vydání: | 1973 |
| Předmět: |
Adult
Male Liver perfusion Swine Spontaneous recovery Electroencephalography Extracorporeal Pregnancy medicine Animals Humans Assisted Circulation Stage (cooking) Coma medicine.diagnostic_test business.industry Liver failure Brain General Medicine Middle Aged Perfusion Liver Anesthesia Hepatic Encephalopathy Female medicine.symptom business |
| Zdroj: | The Quarterly journal of medicine. 42(167) |
| ISSN: | 0033-5622 |
| Popis: | The electroencephalogram (EEG) has been used in the assessment and selection of patients in coma due to acute liver failure for extracorporeal pig-liver perfusion. The response during and following perfusion was also monitored using the EEG. In 55 consecutive patients a stage of the EEG was recognized beyond which spontaneous recovery has not been seen. This stage is characterized by a decreasing amplitude associated with a low frequency, blunting of triphasic waves, if previously present, and periods of flattening. Five patients who had reached this stage were treated by liver perfusion. Following perfusion, two patients, including one who initially had no cerebral activity, fully regained consciousness and have survived 24 and 30 months. The EEG in these patients showed a dramatic improvement following perfusion but full return to normal was not seen for four weeks although they were conscious within 48 hours. A further two patients improved clinically although the EEG remained featureless and of low amplitude; both died. The persistence of an EEG of low amplitude and with little or no rhythmic activity is ominous despite the initial clinical improvement. The fifth patient died shortly after perfusion before a further EEG was recorded. Studies of cerebral metabolism showed a good correlation with the EEG and clinical state in three of four patients before and after perfusion. EEG monitoring should be part of the routine management of patients with acute hepatic failure. The EEG has been useful in the assessment of these patients and has been shown to improve following liver perfusion. |
| Databáze: | OpenAIRE |
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