The summaries are free for public
use. The Chronic Liver Disease
Foundation will continue to add and
archive summaries of articles deemed
relevant to CLDF by the Board of
Trustees and its Advisors.
Abstract Details
Important Unresolved Questions in the Management of Hepatic Encephalopathy: An ISHEN Consensus
Am J Gastroenterol. 2020 Jul;115(7):989-1002. doi: 10.14309/ajg.0000000000000603.
Jasmohan S Bajaj1, Mette Lauridsen2, Elliot B Tapper3, Andres Duarte-Rojo4, Robert S Rahimi5, Puneeta Tandon6, Debbie L Shawcross7, Dominique Thabut8, Radha K Dhiman9, Manuel Romero-Gomez10, Barjesh C Sharma11, Sara Montagnese12
Author information
1Virginia Commonwealth University, McGuire VA Medical Center, Richmond, Virginia, USA.
2Hospital of South West Jutland, Esbjerg, Denmark.
3University of Michigan, Ann Arbor, Michigan, USA.
4University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
5Baylor University Medical Center, Dallas, Texas, USA.
6University of Alberta, Edmonton, Alberta, Canada.
7King's College Hospital, London, United Kingdom.
8Paris Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France.
9Postgraduate Institute of Medical Education & Research, Chandigarh, India.
10University of Seville, Seville, Spain.
11GB Pant Hospital, New Delhi, India.
12Department 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.