Case of the Month #16 - cerebral oedema

Published 02/02/2022

What are the risk factors for cerebral oedema and raised ICP in fulminant liver failure?

  • Hyper acute presentation (i.e. paracetamol overdose)
  • Age < 40
  • Ammonia > 150 μmol/L
  • High level of vasopressor support
  • Renal dysfunction/Metabolic acidosis

Following intubation the patient’s BP is 70/40 mmHg despite 3 litres of fluid resuscitation. The INR has worsened to 8 and platelets are 70 x 109/L.