Affordable Access

Publisher Website

The management of hepatic coma in relation to protein withdrawal and certain specific measures

Authors
Journal
The American Journal of Medicine
0002-9343
Publisher
Elsevier
Publication Date
Volume
23
Issue
1
Identifiers
DOI: 10.1016/0002-9343(57)90358-3
Disciplines
  • Biology
  • Medicine

Abstract

Abstract The response to treatment in sixty-five episodes of hepatic coma was studied in sixty-three patients. Thirty-four patients were treated with a regimen of protein withdrawal, oral broad-spectrum antibiotics and enemas, which had the object of reducing the formation and absorption of toxic nitrogenous substances of intestinal origin. Twenty-one patients improved during treatment and thirteen recovered. Of thirty patients who received varying amounts of protein during hepatic coma, five showed improvement and two survived, but the two groups were not entirely comparable. Additional therapy with glutamic acid, aspartic acid, cortisone, hydrocortisone or lipoic acid was given on forty-seven occasions. No additional benefit could be attributed to the exhibition of these specific agents, and it was concluded that the therapy of choice was protein withdrawal and oral administration of broad-spectrum antibiotics. The majority of those treated were alcoholic patients with severe liver disease, and hepatic function was the most important factor in prognosis. Protein withdrawal and antibiotics reduced arterial blood ammonia concentrations. Like glutamic acid, aspartic acid had a transient effect on blood ammonia values in two patients. Lipoic acid had no constant effect on arterial blood ammonia, pyruvate or α-ketoglutarate concentrations.

There are no comments yet on this publication. Be the first to share your thoughts.

Statistics

Seen <100 times
0 Comments

More articles like this

The management of hepatic coma in relation to prot...

on The American Journal of Medici... July 1957

Management of hepatic coma.

on Rocky Mountain medical journal August 1958

Management of hepatic coma.

on The American Journal of Gastro... July 1958

The management of hepatic coma.

on The Medical clinics of North A... September 1962
More articles like this..