The "Plateau" Phenomenon of Stepwise Extracorporeal Albumin Dialysis Bispectral Index Hepatic Encephalopathy Recovery

A A Case Rep. 2015 Dec 15;5(12):219-22. doi: 10.1213/XAA.0000000000000226.

Abstract

The Bispectral Index™ monitor, an electroencephalographic-derived parameter, can quantify hepatic encephalopathy cerebral function recovery and differentiate between West Haven grades 1 to 4. I report a very peculiar "plateau" phenomenon of 3 clear distinct plateaus of stepwise albumin dialysis Bispectral Index hepatic encephalopathy recovery during an 8-hour Molecular Adsorbent Recirculating System™ (MARS™) liver-assist extracorporeal detoxification, manifesting in conjunction with 3 West Haven grade recoveries. In the patients, I observed recovery of cerebral function after hepatic encephalopathy as a series of plateaus with abrupt transitions between the plateaus, rather than the gradual recovery I anticipated.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Albumins*
  • Hepatic Encephalopathy / therapy*
  • Humans
  • Liver Failure
  • Middle Aged
  • Renal Dialysis*
  • Sorption Detoxification / instrumentation
  • Sorption Detoxification / methods*

Substances

  • Albumins