Delectrious effect of branched chain amino acid enriched solution in acute severe and fulminant hepatitis.

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  • INOUE Kazuaki
    Division of Gastroenterology, Showa University Fujigaoka Hospital
  • YOSHIBA Makoto
    Division of Gastroenterology, Showa University Fujigaoka Hospital
  • SEKIYAMA Kazuhiko
    Division of Gastroenterology, Showa University Fujigaoka Hospital
  • KOH Ichiu
    Division of Gastroenterology, Showa University Fujigaoka Hospital
  • FUJITA Rikiya
    Division of Gastroenterology, Showa University Fujigaoka Hospital

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Other Title
  • 急性肝不全患者における特殊組成アミノ酸製剤投与による肝性脳症増悪の危険性

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Description

It has been suggested by an annual surveillance study that the use of Fischer's branched chain enriched amino acid solution lowers the survival rate of patients with fulminant hepatic failure (FHF). In order to ascertain whether the Fischer's solution is deleterious in FHF, we assessed coma level and plasma levels of substances closely related to urea cycle functions before and after the infusion of the Fischer's solution in cases with FHF and acute severe hepatitis (ASH).<BR>Three patients with FHF and a patient with ASH underwent two hour infusion of Fischer's solution, and changes in coma grade and plasma level of ammonia, urea, glutamine and alanine were sequentially monitored.<BR>One patient with FHF fell into deep coma six hours after the end of the infusion. Two patients, one with FHF and one with ASH, showed nausea, vomiting and disturbance in conducting the number connection test. Remaining one was persistently in deep coma. Ammonia, glutamine and alanine were elevated after the start of the infusion, and sustained in high levels until 24 hours after the end of the infusion in the two coma patients.<BR>These observations imply that infusion of Fischer's solution is deleterious in FHF because it can elevate plasma ammonia level and deteriorate hepatic coma.

Journal

  • Kanzo

    Kanzo 36 (7), 401-407, 1995

    The Japan Society of Hepatology

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