Entrar/Registro  
HOME SPANISH
 
Medicina Interna de México
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Medicina Interna de México >Year 2016, Issue 4


Ramírez-Palma A, Muñoz-Hernández E, Melchor-López A
Comparison of the administration of lactulose and metronidazol vs lactulose or metronidazol in the treatment of acute liver encephalopathy
Med Int Mex 2016; 32 (4)

Language: Español
References: 15
Page: 420-425
PDF: 628.08 Kb.


Full text




ABSTRACT

Background: Hepatic encephalopathy (HE) is a neuropsychiatric syndrome. HE is characterized for a cognitive and motor deficiency with different severity states. Despite HE has been treated for many years, there is not definitive evidence about the therapeutic effects.
Objetive: To analyze if a combined therapy of oral (OV) lactulose and intravenous (IV) metronidazole decrease the hospital stay compared with oral lactulose or IV or OV metronidazole monotherapy.
Material and Method: A retrospective study was made. We analyzed 60 medical records from patients with HE diagnosis (West Haven grade II-IV) from Xoco General Hospital, Mexico City. Patients were divided into three groups according with therapy: metronidazole + lactulose (n=23), metronidazole (n=24) and lactulose (n=13). Statistical analysis was made in VassarStats. ANOVA was used to compare differences between groups.
Results: When correlating the hospital stay with type of therapy administered for the three groups there was a value p=0.15. Variables as HE grade, type of therapy and hospital stay time correlated p=0.12 in patients with HE grade II and p=0.03 for HE grade III patients.
Conclusion: Monotherapy or combination of metronidazole and lactulose did not decrease the hospital stay of HE grade II patients. HE grade IV patients with metronidazole + lactulose therapy, however, had decreased hospital stay


Key words: hepatic encephalopathy, metronidazole, lactulose.


REFERENCIAS

  1. Torre Delgadillo A. Tratamiento de la ascitis y la encefalopatía hepática. Revista de Gastroenterología de México 2010;Supl. 2:164-167.

  2. Torre Delgadillo A. Encefalopatía hepática. Revista de Gastroenterología de México 2010;Supl. 1:190-192.

  3. Rasm Al Sibae M, McGuire BM. Current trends in the treatment of hepatic encephalopathy. Ther Clin Risk Management 2009;5:617-626.

  4. Munoz Santiago J. Hepatic encephalopathy. Med Clin N Am 2008;92:795-812.

  5. Dileep KA, Ravi P, Mullen KD. Pathogenesis, diagnosis, and treatment of hepatic encephalopathy. J Clin Exp Hepatol 2011;1:77-86.

  6. Wright G, Jalan R. Management of hepatic encephalopathy in patients with cirrhosis. Best Practice & Research Clinical Gastroenterology 2007;21:95e110.

  7. McAvoy NC, Hayes PC. Hepatic encephalopathy. Management problems in liver disease. Medicine 2006;35:2.

  8. Shawcross DL, Davies NA, Williams R, Jalan R. Systemic inflammatory response exacerbates the neuropsychological effects of induced hyperammonemia in cirrhosis. J Hepatol 2004;40:247-254.

  9. Aguilar Reina J, Serrano P, Berenguer J, Bruguera M y col., editores. Tratamiento de las enfermedades hepáticas y biliares. Madrid: Elba & Asociación Española para el Estudio del Hígado, 2001;139-145.

  10. Blei AT, Cordoba J. Hepatic encephalopathy. Practice guidelines of the American College of Gastroenterology. Am J Gastroenterol 2001;96:1968-1976.

  11. Als Nielsen B, Gluud Lise L, Gluud C. Non absorbable disaccharides for hepatic encephalopathy: systematic review of randomised trials. BMJ, doi:10.1136/bmj.38048.506134.EE (published 30 March 2004).

  12. Sundaram V, Shaikh OS. Hepatic encephalopathy: Pathophysiology and emerging therapies. Med Clin N Am 2008;93:819-836.

  13. Morgan MH, Read AE, Speller DC. Treatment of hepatic encephalopathy with metronidazole. Gut 1982;23:1-7.

  14. Schiano Thomas D. Treatment options for hepatic encephalopathy. Supplement to Pharmacotherapy 2010;30(5 Pt 2):16S-21S.

  15. García Buey L, González Mateos F, Moreno-Otero R. Cirrosis hepática. Medicine 2012;11:625-633.






>Journals >Medicina Interna de México >Year 2016, Issue 4
 

· Journal Index 
· Links 






       
Copyright 2019