Revue: | Annals of hepatology |
Base de datos: | PERIÓDICA |
Número de sistema: | 000418110 |
ISSN: | 1665-2681 |
Autores: | Gundling, Felix1 Zelihic, Edin1 Seidi, Holger1 Haller, Bernhard2 Umgelter, Andreas3 Schepp, Wolfgang1 Dodt, Christoph1 |
Instituciones: | 1Technical University of Munich, Bogenhausen Academic Teaching Hospital, Munich, Baviera. Alemania 2Technical University of Munich, Institute for Medical Statistics and Epidemiology, Munich, Baviera. Alemania 3Technical University of Munich, Medizinische Klinik, Munich, Baviera. Alemania |
Año: | 2013 |
Periodo: | Feb |
Volumen: | 12 |
Paginación: | 108-114 |
País: | México |
Idioma: | Inglés |
Tipo de documento: | Artículo |
Enfoque: | Aplicado, analítico |
Resumen en inglés | Blood ammonia-measurements are often performed in the emergency departments to diagnose or rule out hepatic encephalopathy (HE). However, the utility and correct interpretation of ammonia levels is a matter of discussion. At this end the present prospective study evaluated whether blood ammonia levels coincide with HE which was also established by the West Haven criteria and the critical flicker frequency, respectively. Material and methods. In 59 patients with known cirrhosis ammonia-levels were determined and patient were additionally categorized by the West-Haven criteria and were also evaluated psychophysiologically using the critical flicker frequency, CFF for the presence of HE. Results. When false positive and false negative results were collapsed the determination of blood ammonia levels alone resulted in 40.7% in a misdiagnoses of HE compared to the West-Haven criteria (24/59 when using West-Haven criteria, 95% confidence interval [CI], 28.1% to 54.3%) and 49.2% when compared with the results of the CFF (29/59, when using CFF, 95% CI, 35.9% to 62.5%). Discussion. Ammonia blood levels do not reliably detect HE and the determination of blood ammonia can not be regarded a useful screening test for HE. Its use as sole indicator for a HE in the Emergency Department may frequently result in frequent misinterpretations |
Disciplinas: | Medicina |
Palabras clave: | Gastroenterología, Diagnóstico, Amoniaco en sangre, Frecuencia crítica de parpadeo, Encefalopatía hepática, Cirrosis hepática, Criterios diagnósticos, Interpretación |
Keyword: | Gastroenterology, Diagnosis, Blood ammonia, Critical flicker frequency, Hepatic encephalopathy, Liver cirrhosis, Diagnostic criteria, Interpretation |
Texte intégral: | Texto completo (Ver PDF) |