My mom is being treated in the hospital for GI bleeding secondary to liver cirrhosis. They didn't give her her lactalose for over 24hours and her ammonia level got up to 280. What permanent brain damage can we expect due to this? What level is too high?
Cirrhosis of liver could have caused liver failure and consequent hepatic encephalopathy. The liver which is decompromised cannot metabolize the waste products hence there is an elevation of blood ammonia levels resulting in encephalopathy. Also, iincreased levels of ammonia may also be seen with gastrointestinal bleeding, where the blood cells are haemolysed in the intestines, releasing protein. The treatment is directed at the cause and in giving life support measures. Lactulose is given to prevent intestinal bacteria from creating ammonia, and as a laxative to remove blood from the intestines. Hepatic encephalopathy could further progress to coma.
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