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dc.contributor.authorSen, Sambit
dc.contributor.authorRose, Christopher F.
dc.contributor.authorYtrebø, Lars M.
dc.contributor.authorDavies, Nathan A.
dc.contributor.authorNedredal, Geir I.
dc.contributor.authorDrevland, Synnøve S.
dc.contributor.authorKjønnø, Marianne
dc.contributor.authorPrinzen, Frits W.
dc.contributor.authorHodges, Stephen J.
dc.contributor.authorDeutz, Nicolaas E. P.
dc.contributor.authorWilliams, Roger
dc.contributor.authorButterworth, Roger F.
dc.contributor.authorRevhaug, Arthur
dc.contributor.authorJalan, Rajiv
dc.date.accessioned2013-04-23T18:36:25Z
dc.date.available2013-04-23T18:36:25Z
dc.date.issued2006-01
dc.identifier.citationSen, S., Rose, C., Ytrebø, L. M., Davies, N. A., Nedredal, G. I., Drevland, S. S., Kjønnø, M., Prinzen, F. W., Hodges, S. J., Deutz, N. E. P., Williams, R., Butterworth, R. F., Revhaug, A. and Jalan, R. (2006) Effect of albumin dialysis on intracranial pressure increase in pigs with acute liver failure: a randomized study. Crit Care Med 34(1):158-164en
dc.identifier.urihttp://hdl.handle.net/1866/9574
dc.subjectCerebral blood flowen
dc.subjectCerebral edemaen
dc.subjectCirculation sanguine cérébraleen
dc.subjectInflammationen
dc.subjectIschémie hépatiqueen
dc.subjectLiver ischemiaen
dc.subjectOedème cérébralen
dc.titleEffect of albumin dialysis on intracranial pressure increase in pigs with acute liver failure: a randomized study
dc.typeArticleen
dc.contributor.affiliationUniversité de Montréal. Faculté de médecinefr
dc.contributor.affiliationUniversité de Montréal. Faculté de médecine. Centre de recherche du CHUM fr
dc.identifier.doi10.1097/01.CCM.0000196203.39832.3C
dcterms.abstractBACKGROUND: Increased intracranial pressure (ICP) worsens the outcome of acute liver failure (ALF). This study investigates the underlying pathophysiological mechanisms and evaluates the therapeutic effect of albumin dialysis in ALF with use of the Molecular Adsorbents Recirculating System without hemofiltration/dialysis (modified, M-MARS). METHODS: Pigs were randomized into three groups: sham, ALF, and ALF + M-MARS. ALF was induced by hepatic devascularization (time = 0). M-MARS began at time = 2 and ended with the experiment at time = 6. ICP, arterial ammonia, brain water, cerebral blood flow (CBF), and plasma inflammatory markers were measured. RESULTS: ICP and arterial ammonia increased significantly over 6 hrs in the ALF group, in comparison with the sham group. M-MARS attenuated (did not normalize) the increased ICP in the ALF group, whereas arterial ammonia was unaltered by M-MARS. Brain water in the frontal cortex (grey matter) and in the subcortical white matter at 6 hrs was significantly higher in the ALF group than in the sham group. M-MARS prevented a rise in water content, but only in white matter. CBF and inflammatory mediators remained unchanged in all groups. CONCLUSION: The initial development of cerebral edema and increased ICP occurs independently of CBF changes in this noninflammatory model of ALF. Factor(s) other than or in addition to hyperammonemia are important, however, and may be more amenable to alteration by albumin dialysis.en
dcterms.bibliographicCitationCritical Care Medicine ; 34(1)
dcterms.languageengen
UdeM.VersionRioxxVersion acceptée / Accepted Manuscript


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