Spinal fluid evacuation in the complex treatment of encephalopathy and coma in viral hepatitis patients
Bulychev, V.V.; Triasuchev, I.O.; Zhil'tsov, I.D.; Nazarov, I.I.; Gol'denberg, A.A.
Klinicheskaia Meditsina 64(1): 127-131
1986
ISSN/ISBN: 0023-2149 PMID: 3959506 Document Number: 268618
External withdrawal of CSF and hemodilution were carried out in 3 patients with virus hepatitis complicated by encephalopathy and coma. The extracellular hypokalemic alkalosis of the CSF (pH 7.87 .+-. 0.04; p < 0.03) and hyperoxemia of the peripheral venous blood (52.5 .+-. 6.6 mm Hg; p < 0.05) are the indirect signs of the lost capacity of the brain cells to utilize oxygen in coma. Hyperoxemia of the CSF (pO2 145.5 .+-. 11.7 mm Hg; p < 0.05) and hypocapnia of the liquor (pCO2 13.8 .+-. 1.13 mm Hg; p < 0.05) were attended by compensatory stenosis of arterioles and blood stasis in the conjunctival capillaries. Substitution withdrawal of CSF and forced diuresis in the combined therapy of encephalopathy and coma in virus hepatitis patients produced therapeutic effect. Signs of the meningeal complications in 2 patients were relieved by antibiotics. There were no cases of coma recurrence. The condition of all 3 patients 2 years after discharge from hospital is satisfactory.