Volume : IX, Issue : VII, July - 2020

PROGNOSTIC RELEVANCE OF ARTERIAL AMMONIA LEVELS IN HEPATIC ENCEPHALOPATHY

Dr. Jyoti Jindal, Dr. Vikas Garg

Abstract :

Objectives of the study is to establish a correlation between arterial ammonia levels and the grade of hepatic encephalopathy and also to determine if the levels of arterial ammonia can be used as a prognostic marker of hepatic encephalopathy. This will result in better management of the patients and also improve the quality of life and reduce the cost burden on our health care system. Methodology : This prospective study was carried out on 100 patients of medicine and gastroenterology department in a tertiary care hospital over a period of 3 months after taking written informed consent Mental status was assessed and graded on admission using THE WEST HAVEN CRITERIA for grading of mental status. Also the APRAXIA CHART method was used for the same for patients in hepatic encephalopathy grade 1 . The diagnosis of hepatic encephalopathy was made when mental status was altered and appropriate laboratory and diagnostic tests excluded other causes. Results : In this study we found a strong correlation of arterial ammonia with grade of hepatic encephalopathy. The highest level of arterial ammonia was seen with grade 3 or 4 of hepatic encephalopathy. Patients with grade 1 or 2 had arterial ammonia <150 umol/l mostly. Out of 100 patients :- 0 patients – grade 0 - with no signs and symtoms , 24 patients – grade 1 (24%), 30 patients – grade 2 (30%) , 26 patients – grade 3 (26 %) , 20 patients – grade 4 (20%) On follow up of 60 patients, 80% (24 out of 30 ) patients in grade 3 and 4 taken together ,improved, that is, their ammonia levels decreased with fall in grade of hepatic encephalopathy. Similarly, 90.9% patients in grade 2 improved (20 out of 22) and 50 % patients in grade 1 (4 out of 8) showed improvement . Conclusion: This correlation between arterial ammonia levels and hepatic encephalopathy and use of this as a prognostic marker will result in better management of the patients and also improve the quality of life and reduce the cost burden on our health care system

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Article: Download PDF    DOI : https://www.doi.org/10.36106/gjra  

Cite This Article:

PROGNOSTIC RELEVANCE OF ARTERIAL AMMONIA LEVELS IN HEPATIC ENCEPHALOPATHY, Dr. JYOTI JINDAL, Dr. VIKAS GARG GLOBAL JOURNAL FOR RESEARCH ANALYSIS : Volume-9 | Issue-7 | July-2020

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