Effect of Goal Directed Ammonia Lowering Therapy in Acute on Chronic Liver Failure Patients With Hepatic Encephalopathy.
Status:
Completed
Trial end date:
2016-01-31
Target enrollment:
Participant gender:
Summary
In this study, all patients with ACLF (Acute on Chronic Liver Failure) with grade III/IV HE
(Hepatic Encephalopathy) getting admitted in our institute will be enrolled after the
fulfilment of inclusion/exclusion criteria and consent of the patient's attendants.
Investigation of the patient (as mentioned in the proforma) will be done.
Intervention step 1:
liq Lactulose 100 mL stat followed by 30 mL/ hourly through NG/NJ route + Lactulose enema 3rd
hourly - till 4 time soft stool is passed, then 30 mL through enteral route 6th hourly (If
patient has no bowel sounds, only enema will be given)
Intervention step 2:
(after 24 hours of introduction of step 1, if no rapid reduction in ammonia to <70mcg/dL)
Randomization to L or R arm R Arm (Addition of Rifaximin) Continuation of Lactulose +
addition of Rifaximin 400 mg 8th hourly through enteral route L Arm (Lactulose only)
Continuation of Lactulose therapy for further 48 hours.