%0 Journal Article %T Hipotermia intravascular inducida en el manejo de la hipertensi¨®n intracraneana en insuficiencia hep¨˘tica aguda: Caso cl¨Şnico Intravascular hypothermia for the management of Intracranial hypertension in acute liver failure: Case report %A Luis Castillo F %A Cristian P¨¦rez R %A Carolina Ruiz B %A Guillermo Bugedo T %J Revista m¨¦dica de Chile %D 2009 %I Sociedad M¨¦dica de Santiago %X Acute liver failure has a mortality rate in excess of 80%. Most deaths are attributed to brain edema with intracranial hypertension and herniation of structures, where ammonium plays a major role in its generation. We report an 18 year-old female with a fulminant hepatic failure caused by virus A infection. The patient developed a profound sopor and required mechanical ventilation. A CT scan showed the presence of brain edema and intracranial hypertension. A Raudemic catheter was inserted to measure intracranial pressure and brain temperature. Intracranial hypertension became refractory and intravascular hypothermia was started, reducing brain temperature to 33ˇăC. Seventy two hours later, a liver transplantation was performed. After testing graft perfusion, rewarming was started, completing 122 hours of hypothermia at 33ˇăC. The patient was discharged in good conditions after 69 days of hospitalization. %K Brain edema %K Hypothermia %K Liver failure %K acute %U http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872009000600010