Carrillo ER, Noriega IMF, Sánchez GR

Language: Spanish
References: 11
Page: 209-213
PDF size: 94.26 Kb.

ABSTRACT

Ammonia is a toxic product of protein metabolism, involving a complex metabolism within different organs, specially the liver where the urea cycle takes place for its elimination. Hyperammonemia has diverse causes and it is associated with deleterious effects, the most serious being cerebral edema and intracranial hypertension. An early and opportunist diagnosis, as well as knowledge of its metabolic cycle and pathophisiologic mechanisms are essential to establish the most appropriate treatment.

REFERENCES

1. Clay A, Hainline B. Hyperammonemia in the ICU. Chest 2007; 132: 1368-78.

2. Brusilow S, Horwich A. Urea cycle enzymes. 8th ed. New York, NY: McGraw-Hill, 2001.

3. Summar M, Barr F, Dawling S et al. Unmasked adult-onset urea cycle disorders in the critical care setting. Crit Care Clin 2005; 21: S1-S8.

4. Hawkes ND, Thomas GA, Jurewicz A et al. Non-hepatic hyperammonaemia: an important, potentially reversible cause of encephalopathy. Postgrad Med J 2001; 77: 717:22.

5. Sass DA, Shakil AO. Fulminant hepatic failure. Liver Transpl 2005; 11: 594-605.

6. Tofteng F, Hauerberg J, Hansen B et al. Persistent arterial hiperammonemia increases the concentration of glutamine and alanine in the brain and correlates with intracranial pressure in patients with fulminant hepatic failure. J Cereb Blood Flow Metab 2006; 26: 21-27.

7. Jalan R. Intracranial hypertension in acute liver failure: pathophysiological basis of rational management. Semin Liver Dis 2003; 23: 271-82.

8. Rahman T, Hodgson H. Clinical management of acute hepatic failure. Intensive Care Med 2001; 27: 467:76.

9. Batshaw ML, MacArthur RB, Tuchman M. Alternative pathway theraphy for urea cycle disorders: twenty years later. J Pediatr 2001; 138: S46-54.

10. Vaquero J, Blei AT. Mild hypothermia for acute liver failure: a review of mechanisms of action. J Clin Gastroenterol 2005; 39: S147-57.

11. Ellis A, Wendon J, Williams P. Subclinical seizure activity and prophylactic phenytoin infusion in acute liver failure: a controlled clinical trial. Hepatology 2000; 38: 536-41.