Down the road towards hepatic encephalopathy. The elusive ammonia– what determines the arterial concentration?

Abstract

HE) in portacaval shunted dogs (Nencki 1895). However, a number of recent reports suggest that elevated ammonia may have more widespread consequences in chronic liver disease. Thus, in acute-on-chronic liver failure, ammonia levels predict 30-day mortality (Verma et al. 2021; Chiriac Introduction-Ammonia and its relation to organ dysfunction in liver diseaseAmmonia has been of interest for hepatologists since the description of elevated ammonia and hepatic encephalopathy