ArticleJournal of cardiothoracic surgery2026
Severe hyperammonemia following coronary artery bypass grafting.
Article in Journal of cardiothoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHyperammonemia is a rare but serious cause of encephalopathy, commonly associated with hepatic dysfunction. However, non-hepatic hyperammonemia (NHHA) can arise due to impaired gastrointestinal transit, urease-producing organisms, and metabolic disorders. We present a case of NHHA following coronary artery bypass grafting (CABG). CASE PRESENTATION: A 56-year-old male with chronic alcohol use developed post-operative ileus and altered mental status on post-operative day 5 after an uncomplicated CABG. Despite normal liver function, ammonia levels peaked at 256 µmol/L. Given ileus, conventional therapy was deferred and continuous renal replacement therapy (CRRT) was initiated, resolving encephalopathy.
conclusionsNHHA should be considered in post-cardiac surgery patients presenting with altered mental status. Early recognition and CRRT intervention are crucial to prevent neurological deterioration.
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