hepatic encephalopathy

MayisontheWay · Apr 10, 2008

waste products that cannot be filtered out (metabolized) by the liver...the biggest culprit is usually ammonia. how it causes encephalopathy is not well understood, but it does.

BlueRidgeHomeRN · Apr 10, 2008

saw this several times in hospice, usually in terminal alcoholics. the ammonia levels rising due to a non-functioning liver "pickle" the brain. we treated with lactulose, which binds some of the ammonia, allowing it to be excreted in feces. it was not a cure, only palliative.

tanthalas · Apr 10, 2008

Lactulose stat!

leslie :-D · Apr 10, 2008

saw this several times in hospice, usually in terminal alcoholics. the ammonia levels rising due to a non-functioning liver "pickle" the brain. we treated with lactulose, which binds some of the ammonia, allowing it to be excreted in feces. it was not a cure, only palliative.

it's a peaceful death...

leslie

Columnist · Apr 10, 2008

It is very difficult for the family members to see their loved one go through this.

cardiacRN2006, ADN, RN · Apr 10, 2008

Has anyone worked with someone with hepatic encephalopathy? What causes this?

Oh, lots of times. But having it doens't mean you are dying. Lots of people take the lactulose, bring the ammonia down, and leave AMA to get their drink on. It's a revolving door...

The problem lies in compliance. Not only do you have to stop drinking, but you have to take a medication that gives you the runs.

Columnist · Apr 10, 2008

Hepatic encephalopathy is not always the result of alcoholism.

Cirrhosis can be caused by other things as well...such as Hepatitis.

leslie :-D · Apr 10, 2008

it's a peaceful death...
leslie

i need to clarify.

the chronic, progressive he, results in a peaceful death.

acute he is mostly reversible.

and yes, it is very disturbing for a loved one to watch the various stages the pt experiences.

ea pt presents differently.

approx 80%+ die when comatose.

leslie

cardiacRN2006, ADN, RN · Apr 10, 2008

Hepatic encephalopathy is not always the result of alcoholism.
.

No, of course not. But, 99% of the ones I see are caused by alcoholism.

mianders, RN · Apr 10, 2008

I watched my dad die of cirrhosis of the liver. He fought hepatic encephalopathy for years. He was on massive doses of lactulose at the end. He suffered tremendously. It was not a peaceful death. I watched him in his final hours gasping for air even though he was in a coma. He was an alcoholic but had given up drinking in the last few years of his life, but by then it was to late. It is a horrible disease.

cardiacRN2006, ADN, RN · Apr 10, 2008

I'm sorry to hear that mianders...