Relationship between the incidence of non-hepatic hyperammonemia and the prognosis of patients in the intensive care unit  

作　　者：Zhi-Peng Yao Yue Li Yang Liu Hong-Liang Wang 

机构地区：[1]Department of Intensive Care Medicine,The Second Affiliated Hospital of Harbin Medical University,Harbin 150001,Heilongjiang Province,China

出　　处：《World Journal of Gastroenterology》2020年第45期7222-7231,共10页世界胃肠病学杂志（英文版）

基　　金：Supported by Scientific research project of Heilongjiang Health and Family Planning Commission,No.2019045.

摘　　要：BACKGROUND Ammonia is a normal constituent of body fluids and is found mainly through the formation of urea in the liver.Blood levels of ammonia must remain low as even slightly elevated concentrations(hyperammonemia)are toxic to the central nervous system.AIM To examine the relationship between the incidence of non-hepatic hyperammonemia(NHH)and the prognosis of patients who were admitted to the intensive care unit(ICU).METHODS This is a prospective,observational and single-center study.A total of 364 patients who were admitted to the ICU from November 2019 to February 2020 were initially enrolled.Changes in the levels of blood ammonia at the time of ICU admission and after ICU admission were continuously monitored.In addition,factors influencing the prognosis of NHH patients were analyzed.RESULTS A total of 204 patients who met the inclusion criteria were enrolled in this study,including 155 NHH patients and 44 severe-NHH patients.The incidence of NHH and severe-NHH was 75.98% and 21.57%,respectively.Patients with severe-NHH exhibited longer length of ICU stay and higher Acute Physiologic Assessment and Chronic Health Evaluation and Sequential Organ Failure Assessment scores compared to those with mild-NHH and non-NHH.Glasgow Coma Scale scores of patients with severe-NHH were than those of non-NHH patients.In addition,the mean and initial levels of ammonia in the blood might be helpful in predicting the prognosis of NHH.CONCLUSION High blood ammonia level is frequent among NHH patients admitted to the ICU,which is related to the clinical characteristics of patients.Furthermore,the level of blood ammonia may be helpful for prognosis prediction.

关 键 词：Non-hepatic hyperammonemia Intestinal absorption Blood ammonia level Metabolism of amino acid Severe patients Intensive care unit 

分 类 号：R589.3[医药卫生—内分泌]