Source Trauma Intensive Care Unit, University of Pittsburgh Medical Center-Presbyterian Hospital in Pittsburgh, PA, USA.
Hepatic encephalopathy (HE) is responsible for an average of 50,000 hospitalizations of approximately 5.5 million individuals with liver cirrhosis every year. HE is a reversible complication of liver failure that causes neuropsychiatric problems. HE patients experience neurologic changes related to cognitive, psychiatric, and motor impairment. This impairment can be accompanied by a number of symptoms including decreased mental status, memory impairment, sensory changes, lack of concentration, disorientation, and coma. The exact cause of HE in patients with liver cirrhosis is unknown. However, the general consensus is that these individuals are unable to remove toxic substances, especially from ammonia-producing bacteria, from the gut via the liver. Therefore, treatment is focused on decreasing the production of these ammonia-producing bacteria, as episodes occur.