Year of publication | Author | Single or multi-center | Number of patients | Type of invasive monitor used | Coagulopathy reversal strategy | Consistent use of a single protocol? | Post-procedure imaging required in all patients? | Incidence of intracranial hemorrhage | Incidence of elevated ICP |
---|---|---|---|---|---|---|---|---|---|
1980 | Hanid et al. | Single-center | 10 | Subdural 100% | FFP 2 units during procedure | Yes | No | 14% | 100% |
1982 | Canalese et al. | Single- center clinical trial of mannitol and dexamethasone | 17 | Subdural and epidural | FFP during procedure | Yes | No | None reported | 82% |
1989 | Forbes et al. | Single-center clinical trial of thiopental in ALF | 13 | Epidural 100% | Not specified | N/A | No | None reported | 100% |
1991 | Munoz et al. | Single-center | 14 | Epidural 100% | FFP and plasma exchange to goal prothrombin time <16Â seconds | Yes | No | None reported | 80% |
1992 | Lidofsky et al. | Single- center | 23 (20 adults, 3 children) | Subdural 91%; epidural 9% | FFP to goal prothrombin time within 3–5 seconds of control; fibrinogen goal 100 mg/dL; platelet transfusion to goal 75,000/μL | Yes | No | 22% (symptomatic 17%) | 43% |
1993 | Keays et al. | Single-center | 36 | Epidural 100% | None | N/A | No | 3% (symptomatic 0%) | 26% |
1993 | Blei et al. | Multi-center | 262 | Epidural 61%; subdural 30%; intraparenchymal 9% | Not specified | No | No | Overall 8% (fatal 4%); epidural 3% (fatal 1%); subdural 18% (fatal 5%); intraparenchymal 13% (fatal 4%) | Not evaluated |
2005 | Vaquero et al. | Multi-center (ALFSG) | 58 | Subdural 64%; intraparenchymal 21%; epidural 16% | FFP 91%; platelets 31%; rFVIIa 26%; cryoprecipitate 19%; plasmapheresis 5% | No | No | Overall 10% (symptomatic 5%); subdural 11% (symptomatic 8%); epidural 11% (symptomatic 11%), intraparenchymal 8% (symptomatic 0%) | Not reported |
2008 | Raschke et al. | Single-center | 22 | Intraparenchymal 100% | rFVIIa plus FFP to goal prothrombin time <16 seconds; platelet transfusion to goal >100,000/μL; fibrinogen goal 100 mg/dL; desmopressin 30 μg/kg IV × 1 | Yes | No | 3/17 (18%) overall | 95% |
2010 | Le et al. | Single- center | 11 | Intraparenchymal 100% | rFVIIa average dose 3 mg (36.7 μg/kg), monitor then placed within 2 hours without rechecking INR | Yes | Yes | None | None |
2012 | Kamat et al. | Single-center | 14 children | Intraparenchymal 100% | rFVIIa plus FFP within 30 mins prior to procedure to achieve INR ≤1.5; vitamin K | Yes | Not reported | Symptomatic 7% | Not reported |
2014 | Karvellas et al. | Multi-center (ALFSG) | 140 | Subdural 27%; intraparenchymal 24%; epidural 23%; lumbar 17%; external ventricular drain 9%; | FFP 84%; platelet transfusion 43%; rFVIIa 2% | No | No | Symptomatic 7% | 51% |
2016 | Maloney et al. | Single-center | 20 | Intraparenchymal 65%; epidural 35% | FFP and rFVIIa to goal INR ≤1.5; platelet transfusion to goal 50,000/μL | Not reported | No | Overall 15% reported. intraparenchymal - 2 of 10 (20%) with imaging available (both fatal); epidural 1 of 3 (33%) - with imaging available (asymptomatic) | 70% |
2016 | Bernal et al. | Multi-center clinical trial of hypothermia in ALF | 43 | Intraparenchymal 100% | Not reported | Not reported | No | None - one remote hemorrhage in the temporal lobe | 44% |
Current study | Rajajee et al. | Single-center | 24 | Intraparenchymal 100% | See Table 1 | Yes | Yes | 4% (symptomatic 0%) | 54% |