Hyperamylasemia and Hyperlipasemia after Cerebral Perfusion Pressure Guided Management in Severe Head Injury: A Case Report

以腦灌流壓為導向治療嚴重頭部損傷致高澱粉酶血症及高血脂症之個案報告

10.29819/ANT.200309.0005

郭進榮(Jinn-Rung Kuo)；王哲川(Che-Chuan Wang)；邱仲慶(Chung-Ching Chio)

Cerebral Perfusion Pressure ； Hyperamylasemia ； Hyperlipasemia

Acta Neurologica Taiwanica

12卷3期（2003 / 09 / 01）

143 - 148

英文

Augmented cerebral perfusion pressure (CPP) of at least 70 mmHg has become a popular treatment for patients with severe head injury. We report a case of a 33-year-old man who suffered from traumatic intracranial hematomas which were successfully evacuated by surgical procedures. Postoperatively the patient received CPP-guided treatment and was sedated with propofoland medicated with vascular volume expanders (hydroxyethyl starch, albumin), systemic vasopressors (norepinephrine, dopamine) as well as mannitol. However, hyperamylasemia and hyperlipasemia happened three days later. Because of the possibility of acute pancreatitis, the patient was prohibited from any oral intake and only intravenous fluids were supplied for 2 days. The amylase and lipase levels decreased gradually after discontinuation of the aforementioned medications. In this article, we review the literature and discuss the possible mechanisms underlying the elevated pancreatic enzymes. We conclude that pancreatitis related to propofol infusion probably plays a role in the pathogenesis of hyperamylasemia and hyperlipasemia in this patient.