hepatic and biliary disorders
Portosystemic Encephalopathy
Treatment of Portosystemic Encephalopathy
Treatment of the cause Bowel cleansing using oral or rectallactuloseor oralpolyethylene glycol3350 Oral nonabsorbable antibiotics such asrifaximinandneomycin help alleviate encephalopathy in Acute Liver Failure . Sedation deepens encephalopathy and should be avoided whenever possible. For coma caused by fulminant hepatitis, meticulous supportive and nursing care coupled with prevention and treatment of complications increase the chance of survival. Hemodialysis can help clear ammonia if there is acute liver failure. High-dose corticosteroids, exchange transfusion, and other complex procedures designed to remove circulating toxins generally do not improve outcome. Patients deteriorating because of fulminant hepatic failure may be saved by Other potential therapies, includinglevodopa,bromocriptine,flumazenil, sodium benzoate, infusions of branched-chain amino acids, keto-analogs of essential amino acids, and prostaglandins, have not proved effective. Complex plasma-filtering systems (artificial liver) show some promise but require more study. 