Intracranial pressure observations in a canine model of acute liver failure supported by a bioartificial liver support system |
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| Authors: | Patzer John F Lopez Roberto C Aggarwal Shushma |
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| Affiliation: | Department of Surgery;;Thomas E. Starzl Transplantation Institute;;Department of Chemical Engineering;;Department of Bioengineering;;McGowan Institute for Regenerative Medicine;and;Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA, USA |
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| Abstract: | Abstract: Life-threatening, severely elevated intracranial pressure (ICP) is a common feature of acute liver failure (ALF). Perfusion with a bioartificial liver may serve to mitigate rising ICP. A retrospective analysis of ICP measurements in a canine ALF model prospectively supported with a bioartificial liver support system (BLSS) is presented. Animals are divided into two groups based upon care provided: (i) standard medical care ( n = 6); and (ii) standard medical care plus BLSS support ( n = 9). Nonparametric analysis with respect to ICP, arterial NH3, lactate, and supportive-care parameters found BLSS-supported animals evidenced significantly less metabolic acidosis than unsupported animals. Analysis of variance/linear regression for direct dependence of ICP on arterial NH3, lactate, and supportive care parameters irrespective of care found ICP was uncorrelated with any measured factor ( P > 0.06 for all factors). Lack of correlation of ICP with the considered parameters indicates that none of these factors are predictive of the extent of ICP elevation in the d -galactosamine canine model. Blood chemistry and supportive care factors that are correlated with and predictive of ICP elevation remain to be identified. |
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| Keywords: | Acute liver failure Intracranial pressure Bioartificial liver |
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