ArticleIntensive care medicine2013
Clinical impact of arterial ammonia levels in ICU patients with different liver diseases.
Article in Intensive care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 55 citations in OpenAlex.
- Hepatic Encephalopathy: Current Thoughts on Pathophysiology and Management.Current neurology and neuroscience reports · 2025Review
- Impact of acute respiratory distress syndrome on outcome in critically ill patients with liver cirrhosis.Scientific reports · 2025Article
- Down the road towards hepatic encephalopathy. The elusive ammonia- what determines the arterial concentration?Metabolic brain disease · 2024Review
- [Liver diseases in the intensive care unit].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Review
- Critical care hepatology: definitions, incidence, prognosis and role of liver failure in critically ill patients.Critical care (London, England) · 2022Review
- Hepatic encephalopathy.Nature reviews. Disease primers · 2022Review
- Prognostic Role of MELD-Lactate in Cirrhotic Patients' Short- and Long-Term Prognosis, Stratified by Causes of Cirrhosis.Canadian journal of gastroenterology & hepatology · 2022Observational
- Article
- An Oral Formulation of the Probiotic,Evidence-based complementary and alternative medicine : eCAM · 2020Article
- [Acute liver failure].Wiener klinisches Magazin : Beilage zur Wiener klinischen Wochenschrift · 2019Review
- [Acute liver failure].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2018Review
- Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC).European journal of heart failure · 2017Review
- A morphological method for ammonia detection in liver.PloS one · 2017Article
- Liver - guardian, modifier and target of sepsis.Nature reviews. Gastroenterology & hepatology · 2017Review
- Outcome and features of acute kidney injury complicating hypoxic hepatitis at the medical intensive care unit.Annals of intensive care · 2016Article
- [Hepatocardiac disorders : Interactions between two organ systems].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2016Review
- Topiramate-induced hyperammonemic encephalopathy in a patient with mental retardation: A case report and review of the literature.Epilepsy & behavior case reports · 2015Article
- [Statin therapy as a protective factor regarding development of hypoxic hepatitis].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2014Review
- Hyperammonia induces specific liver injury through an intrinsic Ca2+-independent apoptosis pathway.BMC gastroenterology · 2014Article
- [Extracorporeal therapy of patients with liver disease in the intensive care unit].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2014Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIncreased arterial ammonia levels are associated with high mortality in patients with acute liver failure (ALF). Data on the prognostic impact of arterial ammonia is lacking in hypoxic hepatitis (HH) and scarce in critically ill patients with cirrhosis.
methodsThe patient cohort comprised 72 patients with HH, 43 patients with ALF, 100 patients with liver cirrhosis and 45 patients without evidence for liver disease. Arterial ammonia concentrations were assessed on a daily basis in all patients and the results were compared among these four patient groups and between 28-day survivors and 28-day non-survivors overall and in each group.
resultsOverall 28-day mortality rates in patients with HH, ALF and cirrhosis and in the control group were 54, 30, 49 and 27 %, respectively. Peak arterial ammonia levels differed significantly between transplant-free 28-day survivors and non-survivors in the HH and ALF groups (p < 0.01 for both). Multivariate regression identified peak arterial ammonia concentrations as an independent predictor of 28-day mortality or liver transplantation in patients with HH and ALF, respectively (p < 0.01). There was no association between mortality and arterial ammonia in patients with liver cirrhosis and in the control group. Admission arterial ammonia levels were independently linked to hepatic encephalopathy grades 3/4 in patients with HH (p < 0.01), ALF (p < 0.05) and cirrhosis (p < 0.05), respectively.
conclusionsElevated arterial ammonia levels indicate a poor prognosis in acute liver injury and are associated with advanced HE in HH, ALF and cirrhosis. Arterial ammonia levels provide additional information in the risk assessment of critically ill patients with liver disease.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.