Predictive value of arterial ammonia for complications and outcome in acute liver failure

Background and aim: In acute liver failure (ALF), the brain is exposed to high levels of ammonia. Human studies defining the clinical significance of ammonia in ALF are lacking. This prospective study evaluated the relationship of arterial ammonia levels at admission to complications and survival am...

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Bibliographic Details
Published in:Gut 2006-01, Vol.55 (1), p.98-104
Main Authors: Bhatia, V, Singh, R, Acharya, S K
Format: Article
Language:English
Subjects:
acute liver failure
Adolescent
Adult
Aged
ALF
Ammonia
Ammonia - blood
Antibiotics
Antigens
Biological and medical sciences
Biomarkers - blood
Blood pressure
cerebral oedema
encephalopathy
Epidemiologic Methods
Female
Gastroenterology
Gastroenterology. Liver. Pancreas. Abdomen
HCV
Hepatic Encephalopathy - blood
Hepatitis
hepatitis C virus
Humans
Liver
Liver cirrhosis
Liver Failure, Acute - blood
Liver Failure, Acute - complications
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
Middle Aged
Mortality
Multivariate analysis
odds ratio
Other diseases. Semiology
Partial Pressure
partial pressure of ammonia
Patients
pNH3
Prognosis
receiver operating characteristic
ROC
Seizures - blood
Severity of Illness Index
Urine
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Summary:Background and aim: In acute liver failure (ALF), the brain is exposed to high levels of ammonia. Human studies defining the clinical significance of ammonia in ALF are lacking. This prospective study evaluated the relationship of arterial ammonia levels at admission to complications and survival among patients with ALF. Methods: Eighty consecutive ALF patients admitted from March 2001 to December 2003 were followed up until death or complete recovery. All had arterial ammonia estimation at admission (enzymatic method). Logistic regression analysis was performed to identify independent predictors of mortality. Results: Forty two (52.5%) patients died. Non-survivors had significantly higher median ammonia levels than survivors (174.7 v 105.0 μmol/l; p
ISSN:0017-5749
1468-3288
DOI:10.1136/gut.2004.061754