Increased Intracranial Pressure during Hemodialysis in a Patient with Anoxic Brain Injury

Joint Authors

Lund, Anton
Damholt, Mette B.
Strange, Ditte G.
Kelsen, Jesper
Møller-Sørensen, Hasse
Møller, Kirsten

Source

Case Reports in Critical Care

Issue

Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-4, 4 p.

Publisher

Hindawi Publishing Corporation

Publication Date

2017-03-20

Country of Publication

Egypt

No. of Pages

4

Main Subjects

Diseases

Abstract EN

Dialysis disequilibrium syndrome (DDS) is a serious neurological complication of hemodialysis, and patients with acute brain injury are at increased risk.

We report a case of DDS leading to intracranial hypertension in a patient with anoxic brain injury and discuss the subsequent dialysis strategy.

A 13-year-old girl was admitted after prolonged resuscitation from cardiac arrest.

Computed tomography (CT) revealed an inferior vena cava aneurysm and multiple pulmonary emboli as the likely cause.

An intracranial pressure (ICP) monitor was inserted, and, on day 3, continuous renal replacement therapy (CRRT) was initiated due to acute kidney injury, during which the patient developed severe intracranial hypertension.

CT of the brain showed diffuse cerebral edema.

CRRT was discontinued, sedation was increased, and hypertonic saline was administered, upon which ICP normalized.

Due to persistent hyperkalemia and overhydration, ultrafiltration and intermittent hemodialysis were performed separately on day 4 with a small dialyzer, low blood and dialysate flow, and high dialysate sodium content.

During subsequent treatments, isolated ultrafiltration was well tolerated, whereas hemodialysis was associated with increased ICP necessitating frequent pauses or early cessation of dialysis.

In patients at risk of DDS, hemodialysis should be performed with utmost care and continuous monitoring of ICP should be considered.

American Psychological Association (APA)

Lund, Anton& Damholt, Mette B.& Strange, Ditte G.& Kelsen, Jesper& Møller-Sørensen, Hasse& Møller, Kirsten. 2017. Increased Intracranial Pressure during Hemodialysis in a Patient with Anoxic Brain Injury. Case Reports in Critical Care،Vol. 2017, no. 2017, pp.1-4.
https://search.emarefa.net/detail/BIM-1144384

Modern Language Association (MLA)

Lund, Anton…[et al.]. Increased Intracranial Pressure during Hemodialysis in a Patient with Anoxic Brain Injury. Case Reports in Critical Care No. 2017 (2017), pp.1-4.
https://search.emarefa.net/detail/BIM-1144384

American Medical Association (AMA)

Lund, Anton& Damholt, Mette B.& Strange, Ditte G.& Kelsen, Jesper& Møller-Sørensen, Hasse& Møller, Kirsten. Increased Intracranial Pressure during Hemodialysis in a Patient with Anoxic Brain Injury. Case Reports in Critical Care. 2017. Vol. 2017, no. 2017, pp.1-4.
https://search.emarefa.net/detail/BIM-1144384

Data Type

Journal Articles

Language

English

Notes

Includes bibliographical references

Record ID

BIM-1144384