Ammonemia

 

Indications:

Ammonia is a product of degradation of proteins, it is converted into urea in the liver.

In cases of liver failure, and therefore metabolic transformation, elevation of plasma ammonium observed.

Principle:

The ammonia must be normally converted to urea in the liver.

In severe hepatic impairment, this role more and therefore we find there hyperammonemia.

ammonemiaTechnique:

Deduction of 1 to 2 mL of venous blood, arterial blood sometimes, on heparinized tube.

Kept on ice, the review must be made within one hour of collection.

The assay is enzymatic.

Results:

Normal values:

In blood, the usual normal value is from 15 to 50 micromol / L, or 0.3 to 0.8 mg / L.

Pathological changes:

– Hyperammonemia is usually due to liver failure, especially if drugs such as barbiturates, opioids or diuretics were taken together;

– But this may also be the result of gastrointestinal bleeding with portal hypertension responsible for increased blood residues;

– It is also a possible complication of caval anastomosis;

– If the hyperammonemia is greater than 200 mmol / L in a newborn, one can fear a enzymopathy the urea cycle, why it is so urgent to establish a proper diet (Rye syndrome).

Cost:

B50.

Practical advice:

There is no obvious correlation between the rate of ammonia levels and the importance of hepatic encephalopathy.

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