Book contents
- Neurocritical Care
- Neurocritical Care
- Copyright page
- Contents
- Contributors
- Preface
- Chapter 1 The Neurological Assessment of the Critically Ill Patient
- Chapter 2 Cerebral Blood Flow Physiology and Metabolism in the Neurocritical Care Unit
- Chapter 3 Cerebral Edema and Intracranial Pressure in the Neurocritical Care Unit
- Chapter 4 Hypothermia in the Neurocritical Care Unit: Physiology and Applications
- Chapter 5 Analgesia, Sedation, and Paralysis in the Neurocritical Care Unit
- Chapter 6 Airway Management and Mechanical Ventilation in the Neurocritical Care Unit
- Chapter 7 Neuropharmacology in the Neurocritical Care Unit
- Chapter 8 Intracranial Monitoring in the Neurocritical Care Unit
- Chapter 9 Electrophysiologic Monitoring in the Neurocritical Care Unit
- Chapter 10 The Role of Transcranial Doppler as a Monitoring Tool in the Neurocritical Care Unit
- Chapter 11 Ischemic Stroke in the Neurocritical Care Unit
- Chapter 12 Intracerebral Hemorrhage in the Neurocritical Care Unit
- Chapter 13 Management of Cerebral Venous Thrombosis in the Neurocritical Care Unit
- Chapter 14 Subarachnoid Hemorrhage in the Neurocritical Care Unit
- Chapter 15 Status Epilepticus in the Neurocritical Care Unit
- Chapter 16 Neuromuscular Disorders in the Neurocritical Care Unit
- Chapter 17 Management of Head Trauma in the Neurocritical Care Unit
- Chapter 18 Management of Autoimmune Encephalitis in the Neurocritical Care Unit
- Chapter 19 Management of Cerebral Salt-Wasting Syndrome and Syndrome of Inappropriate Antidiuresis in the Neurocritical Care Unit
- Chapter 20 Brain Death in the Neurocritical Care Unit
- Chapter 21 Neuroterrorism and Drug Overdose in the Neurocritical Care Unit
- Chapter 22 Infections of the Central Nervous System in the Neurocritical Care Unit
- Chapter 23 Management of the Spinal Cord Injury in the Neurocritical Care Unit
- Chapter 24 Postoperative Management in the Neurocritical Care Unit
- Chapter 25 Ethical Considerations in the Neurocritical Care Unit
- Chapter 26 Pulmonary Consult: Management of Severe Hypoxia in the Neurocritical Care Unit
- Chapter 27 Management of Refractory Arrhythmias in the Neurocritical Care Unit
- Chapter 28 An Infectious Diseases Consult in the Neurocritical Care Unit
- Chapter 29 A Nephrology Consult in the Neurocritical Care Unit
- Chapter 30 Management of Hepatic Encephalopathy in the Neurocritical Care Unit
- Chapter 31 Hypoxic Encephalopathy in the Neurocritical Care Unit
- Chapter 32 Management of Delirium in the Neurocritical Care Unit
- Chapter 33 Generalized Weakness in the Neurocritical Care Unit
- Chapter 34 Management of Severely Brain-Injured Patients Recovering from Coma in the Neurocritical Care Unit
- Chapter 35 Acute Demyelinating Disorders in the Neurocritical Care Unit
- Chapter 36 Building a Case for a Neurocritical Care Unit
- Chapter 37 Neurointensive (NCCU) Care Business Planning
- Index
- References
Chapter 30 - Management of Hepatic Encephalopathy in the Neurocritical Care Unit
Published online by Cambridge University Press: 24 July 2019
- Neurocritical Care
- Neurocritical Care
- Copyright page
- Contents
- Contributors
- Preface
- Chapter 1 The Neurological Assessment of the Critically Ill Patient
- Chapter 2 Cerebral Blood Flow Physiology and Metabolism in the Neurocritical Care Unit
- Chapter 3 Cerebral Edema and Intracranial Pressure in the Neurocritical Care Unit
- Chapter 4 Hypothermia in the Neurocritical Care Unit: Physiology and Applications
- Chapter 5 Analgesia, Sedation, and Paralysis in the Neurocritical Care Unit
- Chapter 6 Airway Management and Mechanical Ventilation in the Neurocritical Care Unit
- Chapter 7 Neuropharmacology in the Neurocritical Care Unit
- Chapter 8 Intracranial Monitoring in the Neurocritical Care Unit
- Chapter 9 Electrophysiologic Monitoring in the Neurocritical Care Unit
- Chapter 10 The Role of Transcranial Doppler as a Monitoring Tool in the Neurocritical Care Unit
- Chapter 11 Ischemic Stroke in the Neurocritical Care Unit
- Chapter 12 Intracerebral Hemorrhage in the Neurocritical Care Unit
- Chapter 13 Management of Cerebral Venous Thrombosis in the Neurocritical Care Unit
- Chapter 14 Subarachnoid Hemorrhage in the Neurocritical Care Unit
- Chapter 15 Status Epilepticus in the Neurocritical Care Unit
- Chapter 16 Neuromuscular Disorders in the Neurocritical Care Unit
- Chapter 17 Management of Head Trauma in the Neurocritical Care Unit
- Chapter 18 Management of Autoimmune Encephalitis in the Neurocritical Care Unit
- Chapter 19 Management of Cerebral Salt-Wasting Syndrome and Syndrome of Inappropriate Antidiuresis in the Neurocritical Care Unit
- Chapter 20 Brain Death in the Neurocritical Care Unit
- Chapter 21 Neuroterrorism and Drug Overdose in the Neurocritical Care Unit
- Chapter 22 Infections of the Central Nervous System in the Neurocritical Care Unit
- Chapter 23 Management of the Spinal Cord Injury in the Neurocritical Care Unit
- Chapter 24 Postoperative Management in the Neurocritical Care Unit
- Chapter 25 Ethical Considerations in the Neurocritical Care Unit
- Chapter 26 Pulmonary Consult: Management of Severe Hypoxia in the Neurocritical Care Unit
- Chapter 27 Management of Refractory Arrhythmias in the Neurocritical Care Unit
- Chapter 28 An Infectious Diseases Consult in the Neurocritical Care Unit
- Chapter 29 A Nephrology Consult in the Neurocritical Care Unit
- Chapter 30 Management of Hepatic Encephalopathy in the Neurocritical Care Unit
- Chapter 31 Hypoxic Encephalopathy in the Neurocritical Care Unit
- Chapter 32 Management of Delirium in the Neurocritical Care Unit
- Chapter 33 Generalized Weakness in the Neurocritical Care Unit
- Chapter 34 Management of Severely Brain-Injured Patients Recovering from Coma in the Neurocritical Care Unit
- Chapter 35 Acute Demyelinating Disorders in the Neurocritical Care Unit
- Chapter 36 Building a Case for a Neurocritical Care Unit
- Chapter 37 Neurointensive (NCCU) Care Business Planning
- Index
- References
Summary
Hepatic encephalopathy (HE) is a complex neuropsychiatric disorder, manifestations of which range from subtle abnormalities demonstrable only on neuropsychometric testing, such as mild cognitive impairment, psychomotor slowing, and impaired bimanual and visuomotor coordination (referred to as minimal HE or MHE), through to overt manifestations such as disruption of the sleep cycle, disturbed attention span, change in personality, confusion, disorientation, and coma. Aside from the uncommon patient with HE due to a congenital deficiency of an urea cycle enzyme, in whom liver function is otherwise normal, HE occurs as a consequence of severe acute or chronic liver disease or in the setting of porto-systemic venous shunting, the latter arising either spontaneously, usually in the presence of portal venous hypertension complicating cirrhosis, or iatrogenically, following portal venous hypertension-decompressive shunt procedures, both surgical and radiologically placed. Irrespective of the clinical setting in which it arises, the severity of overt HE is traditionally graded using systems such as the West Haven criteria [1] (Table 30.1).
- Type
- Chapter
- Information
- Neurocritical Care , pp. 370 - 381Publisher: Cambridge University PressPrint publication year: 2019