Hepatic encephalopathy is associated with decreased cerebral oxygen metabolism and blood flow, not increased ammonia uptake (original) (raw)
Studies have shown decreased cerebral oxygen metabolism (CMRO 2 ) and blood flow (CBF) in cirrhotic patients with hepatic encephalopathy (HE). It remains unclear, however, whether these disturbances are associated with HE or with cirrhosis itself and how they may relate to arterial blood ammonia concentration and cerebral metabolic rate of blood ammonia (CMRA). We addressed these questions in a paired study design by investigating cirrhotic patients during and after recovery from an acute episode of HE type C. CMRO 2 , CBF, and CMRA were measured by dynamic PET/CT. Ten cirrhotic patients were studied during an acute episode of HE; nine were reexamined after recovery. Nine cirrhotic patients with no history of HE served as controls. Mean CMRO 2 increased from 0.73 µmol oxygen/mL brain tissue/min during HE to 0.91 µmol oxygen/mL brain tissue/min after recovery (paired t-test; P < 0.05).
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