Brain edema in liver failure: Basic physiologic principles and management

Fin Stolze Larsen, Julia Wendon – 6 May 2009 – In patients with severe liver failure, brain edema is a frequent and serious complication that may result in high intracranial pressure and brain damage. This short article focuses on basic physiologic principles that determine water flux across the blood‐brain barrier. Using the Starling equation, it is evident that both the osmotic and hydrostatic pressure gradients are imbalanced across the blood‐brain barrier in patients with acute liver failure. This combination will tend to favor cerebral capillary water influx to the brain.

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