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Excess ammonia likely is a major contributor to the development of hepatic encephalopathy (HE). Because some clinicians routinely order ammonia levels in patients with suspected HE, researchers aimed to determine if checking ammonia levels affects management decisions.
They reviewed records from 1200 consecutive adult patients with cirrhosis and diagnoses of HE who were admitted to a South Carolina medical center from 2005 to 2015. Ammonia levels were drawn for 46% of patients; 60% of tested patients had elevated levels. Amount of lactulose given in the first 48 hours of HE management was similar in the tested and untested groups. Researchers found no correlation between lactulose dose and ammonia level. In a propensity-matched analysis, con…