Author information

1 Virginia Commonwealth University, McGuire VA Medical Center, Richmond, Virginia, USA.

2 Hospital of South West Jutland, Esbjerg, Denmark.

3 University of Michigan, Ann Arbor, Michigan, USA.

4 University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

5 Baylor University Medical Center, Dallas, Texas, USA.

6 University of Alberta, Edmonton, Alberta, Canada.

7 King's College Hospital, London, United Kingdom.

8 Paris Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France.

9 Postgraduate Institute of Medical Education & Research, Chandigarh, India.

10 University of Seville, Seville, Spain.

11 GB Pant Hospital, New Delhi, India.

12 Department of Medicine, University of Padova, Padova, Italy.

Abstract

Management of hepatic encephalopathy (HE) remains challenging from a medical and psychosocial perspective. Members of the International Society for Hepatic Encephalopathy and Nitrogen Metabolism recognized 5 key unresolved questions in HE management focused on (i) driving, (ii) ammonia levels in clinical practice, (iii) testing strategies for covert or minimal HE, (iv) therapeutic options, and (v) nutrition and patient-reported outcomes. The consensus document addresses these topical issues with a succinct review of the literature and statements that critically evaluate the current science and practice, laying the groundwork for future investigations.