The "Plateau" Phenomenon of Stepwise Extracorporeal Albumin Dialysis Bispectral Index Hepatic Encephalopathy Recovery. Issue 12 (15th December 2015)

• Record Type: Journal Article
• Authors: Dahaba, Ashraf A.
• Is Part Of: A & A case reports. Volume 5:Issue 12(2015:Dec.)
• Publication Date: 2015-12-15
• Subjects: Anesthesiology -- Periodicals; Anesthesia -- Periodicals; Anesthesiology; Analgesia; Anesthesiology; Periodicals; 617.9605
• DOI: 10.1213/XAA.0000000000000226
• Languages: English
• ISSNs: 2325-7237

Abstract

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.