Discover and read the best of Twitter Threads about #ramsubbramanian
Most recents (1)
When was the last time you saw a pt with hepatic encephalopathy or lost a pt to cerebral edema from it?
Ever wondered why liver failure causes HE & Cerebral edema? What if conventional Rx fail?
If interested in journey to MARS, keep reading.
Bringing awareness to #neurologists.
Ever wondered why liver failure causes HE & Cerebral edema? What if conventional Rx fail?
If interested in journey to MARS, keep reading.
Bringing awareness to #neurologists.
Pt w/ MVA,G5 liver lac,hepatic art sacrificed,LFT 5k,NH3 250,GCS 4
Pt w/🍺cirrhosis,found down,severe rhabdo,CK📈,NH3 400s,renal shutdown,GCS 5
Pt w/ colon Ca on @KEYTRUDA w/jaundice DILI
Pt w/ liver transplant, p/w intractable pruritus
You got the gist-MARS aka Albumin dialysis
Pt w/🍺cirrhosis,found down,severe rhabdo,CK📈,NH3 400s,renal shutdown,GCS 5
Pt w/ colon Ca on @KEYTRUDA w/jaundice DILI
Pt w/ liver transplant, p/w intractable pruritus
You got the gist-MARS aka Albumin dialysis
Pathyphysiology of cerebral edema in HE.
An article by @EWijdicks elegantly describes it. (PMID:27783916)
In Liver failure (LF), ⬆️NH3 cross BBB, converted to glutamine👉🏻osmotic gradient and CE.
Risk of cerebral edema (CE) ⬆️ with NH3 >200 micro moles/L.
An article by @EWijdicks elegantly describes it. (PMID:27783916)
In Liver failure (LF), ⬆️NH3 cross BBB, converted to glutamine👉🏻osmotic gradient and CE.
Risk of cerebral edema (CE) ⬆️ with NH3 >200 micro moles/L.
