Hepatic encephalopathy

References

Key articles

Vilstrup H, Amodio P, Bajaj J, et al. Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014 Aug;60(2):715-35.Full text  Abstract

European Association for the Study of the Liver. EASL clinical practice guidelines on the management of hepatic encephalopathy. J Hepatol. 2022 Sep;77(3):807-24.Full text  Abstract

Bajaj JS, O'Leary JG, Lai JC, et al. Acute-on-chronic liver failure clinical guidelines. Am J Gastroenterol. 2022 Feb 1;117(2):225-52.Full text  Abstract

Reference articles

1. Vilstrup H, Amodio P, Bajaj J, et al. Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014 Aug;60(2):715-35.Full text  Abstract

2. European Association for the Study of the Liver. EASL clinical practice guidelines on the management of hepatic encephalopathy. J Hepatol. 2022 Sep;77(3):807-24.Full text  Abstract

3. Mandiga P, Foris LA, Bollu PC. Hepatic encephalopathy. StatPearls. Treasure Island, FL: StatPearls Publishing; 2022.Full text  Abstract

4. Jepsen P, Ott P, Andersen PK, et al. Clinical course of alcoholic liver cirrhosis: a Danish population-based cohort study. Hepatology. 2010 May;51(5):1675-82.Full text  Abstract

5. Elsaid MI, Rustgi VK. Epidemiology of hepatic encephalopathy. Clin Liver Dis. 2020 May;24(2):157-74. Abstract

6. Sharma BC, Sharma P, Agrawal A, et al. Secondary prophylaxis of hepatic encephalopathy: an open-label randomized controlled trial of lactulose versus placebo. Gastroenterology. 2009 Sep;137(3):885-91.Full text  Abstract

7. Tarantino G, Citro V, Esposito P, et al. Blood ammonia levels in liver cirrhosis: a clue for the presence of portosystemic collateral veins. BMC Gastroenterol. 2009 Mar 17;9:21.Full text  Abstract

8. Haj M, Rockey DC. Ammonia levels do not guide clinical management of patients with hepatic encephalopathy caused by cirrhosis. Am J Gastroenterol. 2020 May;115(5):723-8. Abstract

9. Gabuzda GJ, Hall PW 3rd. Relation of potassium depletion to renal ammonium metabolism and hepatic coma. Medicine (Baltimore). 1966 Nov;45(6):481-90.Full text  Abstract

10. James JH, Ziparo V, Jeppsson B, et al. Hyperammonaemia, plasma amino acid imbalance, and blood-brain amino acid transport: a unified theory of portal-systemic encephalopathy. Lancet. 1979 Oct 13;2(8146):772-5. Abstract

11. Wijdicks EF. Hepatic encephalopathy. N Engl J Med. 2016 Oct 27;375(17):1660-70. Abstract

12. Raabe W. Ammonium ions abolish excitatory synaptic transmission between cerebellar neurons in primary dissociated tissue culture. J Neurophysiol. 1992 Jul;68(1):93-9. Abstract

13. Schafer DF, Jones EA. Hepatic encephalopathy and the gamma-aminobutyric-acid neurotransmitter system. Lancet. 1982 Jan 2;1(8262):18-20. Abstract

14. Bajaj JS, Heuman DM, Hylemon PB, et al. Altered profile of human gut microbiome is associated with cirrhosis and its complications. J Hepatol. 2014 May;60(5):940-7.Full text  Abstract

15. Acharya C, Sahingur SE, Bajaj JS. Microbiota, cirrhosis, and the emerging oral-gut-liver axis. JCI Insight. 2017 Oct 5;2(19).Full text  Abstract

16. Horowitz ME, Schafer DF, Molnar P, et al. Increased blood-brain transfer in a rabbit model of acute liver failure. Gastroenterology. 1983 May;84(5 Pt 1):1003-11. Abstract

17. Mas A. Hepatic encephalopathy: from pathophysiology to treatment. Digestion. 2006;73 Suppl 1:86-93. Abstract

18. Häussinger D, Schliess F. Pathogenetic mechanisms of hepatic encephalopathy. Gut. 2008 Aug;57(8):1156-65. Abstract

19. Guevara M, Baccaro ME, Torre A, et al. Hyponatremia is a risk factor of hepatic encephalopathy in patients with cirrhosis: a prospective study with time-dependent analysis. Am J Gastroenterol. 2009 Jun;104(6):1382-9. Abstract

20. Bajaj JS, O'Leary JG, Lai JC, et al. Acute-on-chronic liver failure clinical guidelines. Am J Gastroenterol. 2022 Feb 1;117(2):225-52.Full text  Abstract

21. Kalaitzakis E, Björnsson E. Renal function and cognitive impairment in patients with liver cirrhosis. Scand J Gastroenterol. 2007 Oct;42(10):1238-44. Abstract

22. Kumar S, Modi R, Bhandari BM, et al. A head CT is unnecessary in the initial evaluation of a cirrhotic patient with recurrent hepatic encephalopathy. Ann Hepatol. 2018 Aug 24;17(5):810-4. Abstract

23. Bajaj JS, Tandon P, O'Leary JG, et al. Admission serum metabolites and thyroxine predict advanced hepatic encephalopathy in a multicenter inpatient cirrhosis cohort. Clin Gastroenterol Hepatol. 2022 Apr 15 [Epub ahead of print]. Abstract

24. Manzo G, De Gennaro A, Cozzolino A, et al. MR imaging findings in alcoholic and nonalcoholic acute Wernicke's encephalopathy: a review. Biomed Res Int. 2014;2014:503596.Full text  Abstract

25. Horst D, Grace ND, Conn HO, et al. Comparison of dietary protein with an oral, branched chain-enriched amino acid supplement in chronic portal-systemic encephalopathy: a randomized controlled trial. Hepatology. 1984 Mar-Apr;4(2):279-87. Abstract

26. Córdoba J, López-Hellín J, Planas M, et al. Normal protein diet for episodic hepatic encephalopathy: results of a randomized study. J Hepatol. 2004 Jul;41(1):38-43. Abstract

27. Gluud LL, Vilstrup H, Morgan MY. Non-absorbable disaccharides versus placebo/no intervention and lactulose versus lactitol for the prevention and treatment of hepatic encephalopathy in people with cirrhosis. Cochrane Database Syst Rev. 2016 May 6;(5):CD003044.Full text  Abstract

28. Patidar KR, Bajaj JS. Antibiotics for the treatment of hepatic encephalopathy. Metab Brain Dis. 2013 Jun;28(2):307-12.Full text  Abstract

29. McPherson S, Thompson A; British Society of Gastroenterology. Management of hepatic encephalopathy: beyond the acute episode. Dec 2019 [internet publication].Full text

30. Kimer N, Krag A, Møller S, et al. Systematic review with meta-analysis: the effects of rifaximin in hepatic encephalopathy. Aliment Pharmacol Ther. 2014 Jul;40(2):123-32.Full text  Abstract

31. Wang Z, Chu P, Wang W. Combination of rifaximin and lactulose improves clinical efficacy and mortality in patients with hepatic encephalopathy. Drug Des Devel Ther. 2019 Dec 17;13:1-11.Full text  Abstract

32. Leevy CB, Phillips JA. Hospitalizations during the use of rifaximin versus lactulose for the treatment of hepatic encephalopathy. Dig Dis Sci. 2007 Mar;52(3):737-41. Abstract

33. Goh ET, Stokes CS, Sidhu SS, et al. L-ornithine L-aspartate for prevention and treatment of hepatic encephalopathy in people with cirrhosis. Cochrane Database Syst Rev. 2018 May 15;(5):CD012410.Full text  Abstract

34. Butterworth RF, Kircheis G, Hilger N, et al. Efficacy of l-ornithine l-aspartate for the treatment of hepatic encephalopathy and hyperammonemia in cirrhosis: systematic review and meta-analysis of randomized controlled trials. J Clin Exp Hepatol. 2018 Sep;8(3):301-13.Full text  Abstract

35. Zhu GQ, Shi KQ, Huang S, et al. Systematic review with network meta-analysis: the comparative effectiveness and safety of interventions in patients with overt hepatic encephalopathy. Aliment Pharmacol Ther. 2015 Apr;41(7):624-35.Full text  Abstract

36. Gluud LL, Dam G, Les I, et al. Branched-chain amino acids for people with hepatic encephalopathy. Cochrane Database Syst Rev. 2017 May 18;(5):CD001939.Full text  Abstract

37. Bass NM, Mullen KD, Sanyal A, et al. Rifaximin treatment in hepatic encephalopathy. N Engl J Med. 2010 Mar 25;362(12):1071-81.Full text  Abstract

38. Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001 Feb;33(2):464-70.Full text  Abstract

39. Biggins SW, Kim WR, Terrault NA, et al. Evidence-based incorporation of serum sodium concentration into MELD. Gastroenterology. 2006 May;130(6):1652-60.Full text  Abstract

40. Laleman W, Simon-Talero M, Maleux G, et al; EASL-CLIF-Consortium. Embolization of large spontaneous portosystemic shunts for refractory hepatic encephalopathy: a multicenter survey on safety and efficacy. Hepatology. 2013 Jun;57(6):2448-57.Full text  Abstract

41. Philips CA, Kumar L, Augustine P. Shunt occlusion for portosystemic shunt syndrome related refractory hepatic encephalopathy - a single-center experience in 21 patients from Kerala. Indian J Gastroenterol. 2017 Sep;36(5):411-9. Abstract

42. Shehata HH, Elfert AA, Abdin AA, et al. Randomized controlled trial of polyethylene glycol versus lactulose for the treatment of overt hepatic encephalopathy. Eur J Gastroenterol Hepatol. 2018 Dec;30(12):1476-81. Abstract

43. Rahimi RS, Singal AG, Cuthbert JA, et al. Lactulose vs polyethylene glycol 3350-electrolyte solution for treatment of overt hepatic encephalopathy: the HELP randomized clinical trial. JAMA Intern Med. 2014 Nov;174(11):1727-33.Full text  Abstract

44. Hassanein TI, Tofteng F, Brown RS Jr, et al. Randomized controlled study of extracorporeal albumin dialysis for hepatic encephalopathy in advanced cirrhosis. Hepatology. 2007 Dec;46(6):1853-62.Full text  Abstract

45. Heemann U, Treichel U, Loock J, et al. Albumin dialysis in cirrhosis with superimposed acute liver injury: a prospective, controlled study. Hepatology. 2002 Oct;36(4 Pt 1):949-58.Full text  Abstract

46. Dalal R, McGee RG, Riordan SM, et al. Probiotics for people with hepatic encephalopathy. Cochrane Database Syst Rev. 2017 Feb 23;(2):CD008716.Full text  Abstract

47. Bajaj JS, Kassam Z, Fagan A, et al. Fecal microbiota transplant from a rational stool donor improves hepatic encephalopathy: a randomized clinical trial. Hepatology. 2017 Dec;66(6):1727-38.Full text  Abstract

48. Bajaj JS, Salzman NH, Acharya C, et al. Fecal microbial transplant capsules are safe in hepatic encephalopathy: a phase 1, randomized, placebo-controlled trial. Hepatology. 2019 Nov;70(5):1690-703. Abstract

49. Jalan R, Wright G, Davies NA, et al. L-ornithine phenylacetate (OP): a novel treatment for hyperammonemia and hepatic encephalopathy. Med Hypotheses. 2007;69(5):1064-9. Abstract

50. Ventura-Cots M, Arranz JA, Simón-Talero M, et al. Safety of ornithine phenylacetate in cirrhotic decompensated patients: an open-label, dose-escalating, single-cohort study. J Clin Gastroenterol. 2013 Nov-Dec;47(10):881-7. Abstract

51. Zacharias HD, Zacharias AP, Gluud LL, et al. Pharmacotherapies that specifically target ammonia for the prevention and treatment of hepatic encephalopathy in adults with cirrhosis. Cochrane Database Syst Rev. 2019 Jun 17;(6):CD012334.Full text  Abstract

52. Bustamante J, Rimola A, Ventura PJ, et al. Prognostic significance of hepatic encephalopathy in patients with cirrhosis. J Hepatol. 1999 May;30(5):890-5. Abstract

53. Stewart CA, Malinchoc M, Kim WR, et al. Hepatic encephalopathy as a predictor of survival in patients with end-stage liver disease. Liver Transpl. 2007 Oct;13(10):1366-71.Full text  Abstract

54. Bajaj JS, Schubert CM, Heuman DM, et al. Persistence of cognitive impairment after resolution of overt hepatic encephalopathy. Gastroenterology. 2010 Jun;138(7):2332-40.Full text  Abstract

55. Bajaj JS, Wade JB, Gibson DP, et al. The multi-dimensional burden of cirrhosis and hepatic encephalopathy on patients and caregivers. Am J Gastroenterol. 2011 Sep;106(9):1646-53.Full text  Abstract

56. Bajaj JS, Hafeezullah M, Zadvornova Y, et al. The effect of fatigue on driving skills in patients with hepatic encephalopathy. Am J Gastroenterol. 2009 Apr;104(4):898-905. Abstract

57. Ezaz G, Murphy SL, Mellinger J, et al. Increased morbidity and mortality associated with falls among patients with cirrhosis. Am J Med. 2018 Jun;131(6):645-50. Abstract

58. Tapper EB, Halbert B, Mellinger J. Rates of and reasons for hospital readmissions in patients with cirrhosis: a multistate population-based cohort study. Clin Gastroenterol Hepatol. 2016 Aug;14(8):1181-8.Full text  Abstract

59. Joshi D, O'Grady J, Patel A, et al. Cerebral oedema is rare in acute-on-chronic liver failure patients presenting with high-grade hepatic encephalopathy. Liver Int. 2014 Mar;34(3):362-6. Abstract

60. Garrido M, Turco M, Formentin C, et al. An educational tool for the prophylaxis of hepatic encephalopathy. BMJ Open Gastroenterol. 2017;4(1):e000161.Full text  Abstract

61. Kircheis G, Knoche A, Hilger N, et al. Hepatic encephalopathy and fitness to drive. Gastroenterology. 2009 Nov;137(5):1706-15.e1-9.Full text  Abstract

62. Volk ML, Tocco RS, Bazick J, et al. Hospital readmissions among patients with decompensated cirrhosis. Am J Gastroenterol. 2012 Feb;107(2):247-52.Full text  Abstract

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