Anesthesia Medical News about Liver Failure Liver Failure, Acute

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Moderate hypothermia with intracranial pressure monitoring as a therapeutic paradigm for the management of acute liver failure: a systematic review
Intensive Care Medicine, 10/28/09

Dmello D et al. – Limited data exist concerning the safety and efficacy of moderate hypothermia and ICP monitoring for the treatment of ICH in acute liver failure. The available evidence shows that induction of moderate hypothermia in this clinical setting is feasible and possibly efficacious. Well–designed prospective clinical trials are warranted in this challenging context, given the potential of providing a bridge to liver transplantation or even clinical recovery.

Exclusive Author Commentary
Dayton Dmello, 10/28/09

Moderate hypothermia in acute liver failure represents an exciting but challenging aspect of a therapeutic paradigm for the treatment of intracranial hypertension. We seek to allay the apprehension that accompanies the utilization of moderate hypothermia as a therapeutic modality in this clinical setting, fully aware that large-scale randomized trials are needed to better define its long-term effectiveness and utility. Morever, we fully understand the risks involved with concomitant intracranial pressure monitoring, but are cautiously optimistic that the benefits outweigh the risks, based on limited available data from our review. Finally, we also firmly believe that there needs to be an acceptance of this paradigm into the algorithm of acute liver failure management, as this would provide much-needed answers regarding its potential role as a bridge to hepatic regeneration and clinical recovery.

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