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Cerebral Hemodynamics Patterns by Transcranial Doppler in Patients With Acute Liver Failure.
Abdo, A; Pérez-Bernal, J; Hinojosa, R; Porras, F; Castellanos, R; Gómez, F; Gutiérrez, J; Castellanos, A; Leal, G; Espinosa, N; Gómez-Bravo, M.
Afiliação
  • Abdo A; Intensive Care Unit, Centro de Investigaciones Médico Quirúrgicas, La Habana, Cuba. Electronic address: aaabdo@infomed.sld.cu.
  • Pérez-Bernal J; Intensive Care Unit, Hospital Universitario Virgen del Rocío, Sevilla, España.
  • Hinojosa R; Intensive Care Unit, Hospital Universitario Virgen del Rocío, Sevilla, España.
  • Porras F; Intensive Care Unit, Hospital Universitario Virgen del Rocío, Sevilla, España.
  • Castellanos R; Intensive Care Unit, Centro de Investigaciones Médico Quirúrgicas, La Habana, Cuba.
  • Gómez F; Intensive Care Unit, Centro de Investigaciones Médico Quirúrgicas, La Habana, Cuba.
  • Gutiérrez J; Intensive Care Unit, Centro de Investigaciones Médico Quirúrgicas, La Habana, Cuba.
  • Castellanos A; Intensive Care Unit, Centro de Investigaciones Médico Quirúrgicas, La Habana, Cuba.
  • Leal G; Intensive Care Unit, Centro de Investigaciones Médico Quirúrgicas, La Habana, Cuba.
  • Espinosa N; Intensive Care Unit, Centro de Investigaciones Médico Quirúrgicas, La Habana, Cuba.
  • Gómez-Bravo M; Liver Transplantation Unit, Hospital Universitario Virgen del Rocío, Sevilla, España.
Transplant Proc ; 47(9): 2647-9, 2015 Nov.
Article em En | MEDLINE | ID: mdl-26680061
INTRODUCTION: About half of patients with acute liver failure (ALF) show clinical signs of cerebral edema and intracranial hypertension. Neuroimaging diagnostics and electroencephalography have poor correlation with intracranial pressure measurement. OBJECTIVE: The objective of this study was to characterize the cerebral hemodynamics patterns with transcranial Doppler (TCD) sonography in patients with ALF. METHOD: We studied 21 patients diagnosed with ALF, admitted to the intensive care unit (ICU) at the Centro de Investigaciones Médico Quirúrgicas of Cuba. All of these patients had a TCD performed on arrival at ICU, evaluating the following: systolic (SV), diastolic (DV), and medium (MV) flows velocities and pulsatility index (PI) in right middle cerebral artery (RMCA) via temporal windows. RESULTS: The sonographic patterns of cerebral hemodynamics were as follows: low-flow, 12 patients (57.1%); high resistance, 5 patients (23.8%); and hyperemic, 4 patients (19%). Patients who died while waiting had lower MV RMCA (56.1 vs 58.1 cm/s) and higher PI (1.71 vs 1.41) than patients who could undergo transplantation (P = .800 and P = .787, respectively). CONCLUSIONS: In patients diagnosed with ALF admitted to the ICU the predominating cerebral hemodynamic pattern was low-flow with resistance increase. The TCD was shown to be a useful tool in the initial evaluation for prognosis and treatment.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Circulação Cerebrovascular / Falência Hepática Aguda / Ultrassonografia Doppler Transcraniana / Artéria Cerebral Média / Hemodinâmica Tipo de estudo: Etiology_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged País/Região como assunto: Caribe / Cuba Idioma: En Revista: Transplant Proc Ano de publicação: 2015 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
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XML
PubMed Links
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Circulação Cerebrovascular / Falência Hepática Aguda / Ultrassonografia Doppler Transcraniana / Artéria Cerebral Média / Hemodinâmica Tipo de estudo: Etiology_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged País/Região como assunto: Caribe / Cuba Idioma: En Revista: Transplant Proc Ano de publicação: 2015 Tipo de documento: Article País de publicação: Estados Unidos