Hepatic encephalopathy: current management strategies and treatment, including management and monitoring of cerebral edema and intracranial hypertension in fulminant hepatic failure

Current Opinion in Anaesthesiology
Zdravka Zafirova, Michael O'connor

Abstract

Hepatic encephalopathy is a syndrome whose pathophysiology is poorly understood, for which we lack high-quality diagnostic tests and markers, and whose treatment has improved only slightly over the last several decades. Serum ammonia levels remain the diagnostic gold standard. Hepatic encephalopathy can be precipitated by several of the complications of cirrhosis; effective treatment of precipitants is as important as treatment of the encephalopathy itself. Therapy with lactulose and enteral antibiotics is appropriate in any hospitalized patient with more than trivial hepatic encephalopathy. Rifaximin is increasingly important as a therapy for hospitalized patients with hepatic encephalopathy. High-grade encephalopathy continues to carry a high mortality. Current diagnostic tests are imperfect, and modern therapy is nonspecific. No cost-efficient or more effective alternatives to either are likely to enter into clinical practice in the short-term future.

References

Mar 3, 1999·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·J O ClemmesenP Ott
Jul 27, 2001·The American Journal of Gastroenterology·A T BleiUNKNOWN Practice Parameters Committee of the American College of Gastroenterology
Dec 18, 2001·Journal of Neuroscience Research·G BaiM D Norenberg
Mar 1, 2002·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Peter FerenciAndres T Blei
Dec 14, 2002·Journal of Hepatology·Antoni MasUNKNOWN Spanish Association for the Study of the Liver Hepatic Encephalopathy Cooperative Group
Jan 9, 2003·JAMA : the Journal of the American Medical Association·Lise L KjaergardChristian Gluud
Jan 24, 2003·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Michael D Norenberg
Sep 2, 2003·Gastroenterology·Javier VaqueroAndres T Blei
Apr 1, 2004·BMJ : British Medical Journal·Bodil Als-NielsenChristian Gluud
Jul 13, 2004·Journal of Hepatology·Juan CórdobaJaume Guardia
Sep 7, 2004·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Mohammed S KhurooKarim L C Farahat
Nov 30, 2005·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Javier VaqueroAndres T Blei
Jan 27, 2006·World Journal of Gastroenterology : WJG·Mariano MalaguarneraRampello Liborio
Jul 11, 2006·Alimentary Pharmacology & Therapeutics·F GunsarA K Burroughs
Nov 3, 2006·Digestive Diseases and Sciences·Mariano MalaguarneraLiborio Rampello
Aug 10, 2007·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·William BernalJulia Wendon
Nov 3, 2007·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Tarek I HassaneinAndres T Blei
Jan 5, 2008·Neurological Research·Javier Vaquero, Roger F Butterworth
May 10, 2008·European Journal of Gastroenterology & Hepatology·Praveen SharmaShiv Kumar Sarin
Aug 12, 2008·The American Journal of Gastroenterology·Jasmohan S BajajDavid G Binion
Oct 1, 2008·Journal of Gastroenterology and Hepatology·Qian JiangYong-Ping Chen
Dec 3, 2008·European Journal of Gastroenterology & Hepatology·Qian JiangLi Wang

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Citations

Dec 18, 2013·British Journal of Anaesthesia·D KiamaneshV K Moitra
Oct 3, 2012·Home Healthcare Nurse·Mellisa Hall
Mar 22, 2014·The New England Journal of Medicine·William Bernal, Julia Wendon
Mar 20, 2014·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Huy P PhamJoseph Schwartz
Feb 24, 2017·The Cochrane Database of Systematic Reviews·Rohan DalalAngela C Webster
Jun 8, 2018·European Surgery : ACA : Acta Chirurgica Austriaca·Lukas GasteigerWerner Tiefenthaler
Feb 25, 2011·Digestive Diseases and Sciences·Joaquin MerinoJorge-Luis Arias
Mar 28, 2012·Current Opinion in Anaesthesiology·Alexander HoetzelRene Schmidt
Aug 2, 2017·Seminars in Cardiothoracic and Vascular Anesthesia·Akila RajakumarM Susan Mandell
Mar 22, 2014·The New England Journal of Medicine·Harpal S Dhaliwal, Preetmohinder Singh

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