AJG: Blood ammonia levels cannot guide the clinical management of patients with liver and encephalopathy caused by cirrhosis

Introduction and Purpose: Ammonia appears to play a major role in the pathophysiology of hepatic encephalopathy (HE), but its role in guiding treatment is not clearThe purpose of this study was to understand the effect of blood ammonia levels on HE management in hospitalized patientsmethod: The researchers collected data on patients with cirrhosis over the age of 18 who were admitted to hospital for HE treatment between 2005 and 2015Tendentious matching is also used to control the severity of potential diseases to avoid confusionPatients with ammonia levels detected at the time of HE diagnosis are further classified as patients with normal or elevated ammonia levelsThe main endpoint is the total amount of lactose given 48 hours before HE treatmentresults: A total of 1202 patients with HE were identified in this study, and 328 patients (60%) had abnormal ammonia levels (-72?mol/L)There was no significant difference in child-Pugh, MELD or Charlson comorbidities in people with and without ammonia levelsIn the ammonia-free and high ammonia group, the average total lactose dose for 48 hours was 167 and 171 mL, respectively (P - 0.42)The average laccurucine dose was 161 mL in patients with elevated ammonia levels, the same as the lactose dose in patients with normal ammonia levelsThere is no correlation between the lactose dose and ammonia levels (R 2 s 0.0026)discussion: The inpatient management of fractal fructose is not affected by ammonia levels, which indicates that ammonia levels do not guide treatment in clinical practice