Diagnosis and Management of Hepatic Encephalopathy in Fulminant Hepatic Failure

Sudha Kodali, Brendan M. McGuire

Research output: Contribution to journalReview articlepeer-review

25 Scopus citations


Hepatic encephalopathy (HE) is associated with cerebral edema (CE), increased intracranial pressure (ICP), and subsequent neurologic complications; it is the most important cause of morbidity and mortality in fulminant hepatic failure. The goal of therapy should be early diagnosis and treatment of HE with measures to reduce CE. A combination of clinical examination and diagnostic modalities can aid in prompt diagnosis. ICP monitoring and transcranial Doppler help diagnose and monitor response to treatment. Transfer to a transplant center and intensive care unit admission with airway management and reduction of CE with hypertonic saline, mannitol, hypothermia, and sedation are recommended as a bridge to liver transplantation.

Original languageEnglish (US)
Pages (from-to)565-576
Number of pages12
JournalClinics in Liver Disease
Issue number3
StatePublished - Aug 1 2015


  • Ammonia
  • Fulminant hepatic failure
  • Hepatic encephalopathy
  • Hyperammonemia

ASJC Scopus subject areas

  • Hepatology


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