Evidence map›Paper›PMID 34820220›Full record

ArticleCureus2021

Food Coma: Hyperammonemic Encephalopathy From Refeeding Syndrome.

Joseph Khoory, Arashdeep Rupal, Chinmay Jani, Harpreet Singh, Kurt Hu

Open access · diamondAbstract readCase Reports
In one paragraph

Article in Cureus, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 47% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. The Story of Ammonia in Liver Disease: An Unraveling Continuum.Journal of clinical and experimental hepatology
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Joseph KhooryInternal Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, USA.
Arashdeep RupalInternal Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, USA.
Chinmay JaniInternal Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, USA.
Harpreet SinghCritical Care Medicine, Medical College of Wisconsin, Milwaukee, USA.
Kurt HuPulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, USA.
Medical College of Wisconsin · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hyperammonemic encephalopathy (HAE) from extrahepatic causes is increasingly being recognized. Refeeding syndrome is characterized by severe fluid and electrolyte shifts following the reintroduction of nutrition. We describe the case of a 67-year-old man with bilateral maxillary sinus squamous cell carcinoma on nivolumab who became comatose after initiation of enteral feeding. Initial workup was notable for severe hypophosphatemia (<1 mg/dL) and markedly elevated ammonia (226 µmol/L). Neuroimaging was unrevealing. Correction of hypophosphatemia did not improve mental status. Ammonia levels briefly decreased while holding enteral feeding but worsened again on resumption. High-volume continuous renal replacement therapy was recommended but deferred in accordance with family wishes. We hypothesize that HAE may have been precipitated by a combination of refeeding-induced high nitrogen burden and limited detoxification via the urea cycle and extrahepatic pathways in the setting of severe protein-energy malnutrition and underlying malignancy. Nivolumab could have contributed as well.

Indexed as

encephalopathyhyperammonemiarefeeding syndromesquamous cell carcinomaurea cycle disorder

Identifiers

PMID34820220
PMCPMC8601258
OpenAlexW3206320512

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.