Hepatic encephalopathy (HE) is a common complication of advanced liver disease and acute liver failure. It is a condition that features several neuropsychiatric symptoms that affect mortality, morbidity and the quality of patients’ and caregivers’ lives. An HE diagnosis is generally an exclusion diagnosis. Once the patient is admitted to the hospital, clinical examination, blood tests and eventually neuroimaging should be performed with the aim of ruling out other causes of acute brain dysfunction. Moreover, HE is recognized using various precipitants that can potentially promote its onset, alone or in combination, and must be identified. Once the diagnostic process is complete, a correct treatment should be started. The anti-HE treatment is based on a combination of the correction of precipitants; non-absorbable antibiotics, such as rifaximin; and non-absorbable disaccharides. Once the patient is discharged from the hospital, specific anti-HE therapy should be maintained in order to prevent other HE episodes.

The management of hepatic encephalopathy from ward to domiciliary care: current evidence and gray areas / Bellafante, Daniele; Gioia, Stefania; Faccioli, Jessica; Riggio, Oliviero; Ridola, Lorenzo; Nardelli, Silvia. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 13:1(2023), pp. 1-13. [10.3390/jcm13010166]

The management of hepatic encephalopathy from ward to domiciliary care: current evidence and gray areas

Bellafante, Daniele;Gioia, Stefania;Faccioli, Jessica;Riggio, Oliviero;Ridola, Lorenzo;Nardelli, Silvia
2023

Abstract

Hepatic encephalopathy (HE) is a common complication of advanced liver disease and acute liver failure. It is a condition that features several neuropsychiatric symptoms that affect mortality, morbidity and the quality of patients’ and caregivers’ lives. An HE diagnosis is generally an exclusion diagnosis. Once the patient is admitted to the hospital, clinical examination, blood tests and eventually neuroimaging should be performed with the aim of ruling out other causes of acute brain dysfunction. Moreover, HE is recognized using various precipitants that can potentially promote its onset, alone or in combination, and must be identified. Once the diagnostic process is complete, a correct treatment should be started. The anti-HE treatment is based on a combination of the correction of precipitants; non-absorbable antibiotics, such as rifaximin; and non-absorbable disaccharides. Once the patient is discharged from the hospital, specific anti-HE therapy should be maintained in order to prevent other HE episodes.
2023
overt hepatic encephalopathy; minimal hepatic encephalopathy; portosystemic shunts; ammonia; liver cirrhosis
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
The management of hepatic encephalopathy from ward to domiciliary care: current evidence and gray areas / Bellafante, Daniele; Gioia, Stefania; Faccioli, Jessica; Riggio, Oliviero; Ridola, Lorenzo; Nardelli, Silvia. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 13:1(2023), pp. 1-13. [10.3390/jcm13010166]
File allegati a questo prodotto
File Dimensione Formato  
Bellafante_Management_2023.pdf

accesso aperto

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Creative commons
Dimensione 1.06 MB
Formato Adobe PDF
1.06 MB Adobe PDF

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1699174
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 0
  • ???jsp.display-item.citation.isi??? 1
social impact