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When was the last time you saw a pt with hepatic encephalopathy or lost a pt to cerebral edema from it?
Ever wondered why liver failure causes HE & Cerebral edema? What if conventional Rx fail?
If interested in journey to MARS, keep reading.
Bringing awareness to #neurologists.
Ever wondered why liver failure causes HE & Cerebral edema? What if conventional Rx fail?
If interested in journey to MARS, keep reading.
Bringing awareness to #neurologists.
Pt w/ MVA,G5 liver lac,hepatic art sacrificed,LFT 5k,NH3 250,GCS 4
Pt w/🍺cirrhosis,found down,severe rhabdo,CK📈,NH3 400s,renal shutdown,GCS 5
Pt w/ colon Ca on @KEYTRUDA w/jaundice DILI
Pt w/ liver transplant, p/w intractable pruritus
You got the gist-MARS aka Albumin dialysis
Pt w/🍺cirrhosis,found down,severe rhabdo,CK📈,NH3 400s,renal shutdown,GCS 5
Pt w/ colon Ca on @KEYTRUDA w/jaundice DILI
Pt w/ liver transplant, p/w intractable pruritus
You got the gist-MARS aka Albumin dialysis
Pathyphysiology of cerebral edema in HE.
An article by @EWijdicks elegantly describes it. (PMID:27783916)
In Liver failure (LF), ⬆️NH3 cross BBB, converted to glutamine👉🏻osmotic gradient and CE.
Risk of cerebral edema (CE) ⬆️ with NH3 >200 micro moles/L.
An article by @EWijdicks elegantly describes it. (PMID:27783916)
In Liver failure (LF), ⬆️NH3 cross BBB, converted to glutamine👉🏻osmotic gradient and CE.
Risk of cerebral edema (CE) ⬆️ with NH3 >200 micro moles/L.
1/
In early residency, I was in a family meeting.
“Unfortunately, your 55yo loved one has suffered a very large stroke affecting a large portion of the brain. Surgery would reduce the change of death, but not the disability from the stroke.”
True or False? Vote below
In early residency, I was in a family meeting.
“Unfortunately, your 55yo loved one has suffered a very large stroke affecting a large portion of the brain. Surgery would reduce the change of death, but not the disability from the stroke.”
True or False? Vote below
2/
A #tweetorial, #EmoryNCCTweetorial, @medtweetorials about the role of decompressive hemicraniectomy in ischemic stroke.
Vote:
A #tweetorial, #EmoryNCCTweetorial, @medtweetorials about the role of decompressive hemicraniectomy in ischemic stroke.
Vote:
3/
First, I cringe now thinking about this statement, because I was the one that said it 😳😱.
This👏Is👏Not👏True👏
Fortunately, I was corrected. But, unfortunately, I have heard a version of this said on *numerous* occasions since then.
Why all the confusion?
First, I cringe now thinking about this statement, because I was the one that said it 😳😱.
This👏Is👏Not👏True👏
Fortunately, I was corrected. But, unfortunately, I have heard a version of this said on *numerous* occasions since then.
Why all the confusion?
