逐步体外白蛋白透析双谱指数改善肝性脑病的“平台期”现象

The "Plateau" Phenomenon of Stepwise Extracorporeal Albumin Dialysis Bispectral Index Hepatic Encephalopathy Recovery.

作者信息

Dahaba Ashraf A

机构信息

From the Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria.

出版信息

A A Case Rep. 2015 Dec 15;5(12):219-22. doi: 10.1213/XAA.0000000000000226.

DOI:10.1213/XAA.0000000000000226

PMID:26657702

Abstract

The Bispectral Index™ monitor, an electroencephalographic-derived parameter, can quantify hepatic encephalopathy cerebral function recovery and differentiate between West Haven grades 1 to 4. I report a very peculiar "plateau" phenomenon of 3 clear distinct plateaus of stepwise albumin dialysis Bispectral Index hepatic encephalopathy recovery during an 8-hour Molecular Adsorbent Recirculating System™ (MARS™) liver-assist extracorporeal detoxification, manifesting in conjunction with 3 West Haven grade recoveries. In the patients, I observed recovery of cerebral function after hepatic encephalopathy as a series of plateaus with abrupt transitions between the plateaus, rather than the gradual recovery I anticipated.

摘要

脑电双频指数监测仪是一种基于脑电图得出的参数，可量化肝性脑病患者脑功能的恢复情况，并区分韦斯特黑文分级的1至4级。我报告了一种非常特殊的“平台期”现象，即在8小时的分子吸附再循环系统（MARS™）肝脏辅助体外解毒过程中，逐步白蛋白透析的脑电双频指数肝性脑病恢复出现了3个清晰明显的平台期，这与韦斯特黑文分级的3级恢复情况同时出现。在这些患者中，我观察到肝性脑病后脑功能的恢复呈现为一系列平台期，各平台期之间有突然转变，而非我预期的逐渐恢复。