Corrections to the AASLD Position Paper: The Management of Acute Liver Failure | 2011 AASLD

Falência Hepática Aguda 2011

In patients who do not respond to a volume challenge and norepinephrine, vasopressin and its analogues may potentiate the effects of norepinephrine and allow a decrease in its infusion rate, which in turn may avoid intense vasoconstriction in peripheral tissues which can lead to ischemia. However, the use of vasopressin/terlipressin was discouraged by a study reporting cerebral vasodilation and increased ICH in severely encephalopathic patients.1 A more recent study, however, has shown that terlipressin increased CPP and cerebral perfusion without increasing ICP, and concluded that vasopressin and analogues might be useful with norepinephrine to ensure adequate brain perfusion.2 In the US where terlipressin is not yet available, the addition of vasopressin should be considered in hypotensive patients requiring escalating doses of norepinephrine, but should be administered with caution in patients with ICH. Finally, persistence of hypotension despite volume repletion and vasopressors should prompt a trial of hydrocortisone.3, 4

Deixe uma resposta

O seu endereço de email não será publicado.

APEF - ASSOCIAÇÃO PORTUGUESA PARA O ESTUDO DO FÍGADO
Rua Abranches Ferrão, nº 10 - 14º
1600-001 Lisboa Tel: 217995536 
Fax: 217995538
geral@apef.com.pt

Horário de funcionamento:
9.00 - 13.00, 14.00 - 18.00

Secretariado

Luis Maco
Diretor-Geral
luis.maco@apef.com.pt
Andreia Neto
andreia.neto@apef.com.pt
Teresa Jorge
teresa.jorge@apef.com.pt
Cândida Rodrigues

Tornar-se sócio

É favor enviar ao Presidente da APEF, até 3 meses da data da Assembleia Geral, a proposta devidamente preenchida, assinada por dois sócios titulares da APEF e acompanhada das notas curriculares (resumo cv), para: Geral@apef.com.pt ou para

APEF - ASSOCIAÇÃO PORTUGUESA PARA O ESTUDO DO FÍGADO, Rua Abranches Ferrão

Nº10 - 14º 1600-001 Lisboa.

Ficha de Inscrição