Breath-ammonia testing of healthy subjects and patients with cirrhosis.
Dig Dis Sci
; 57(1): 189-95, 2012 Jan.
Article
em En
| MEDLINE
| ID: mdl-21842240
ABSTRACT
BACKGROUND:
Hepatic encephalopathy (HE) is a serious neuropsychiatric complication in both acute and chronic liver disease.AIMS:
To establish the utility of a portable noninvasive method to measure ammonia in the breath of healthy subjects and patients with HE.METHODS:
The study included 106subjects:
44 women and 62 men, 51 healthy and 55 cirrhotic. The breath ammonia was measured with an electrochemical sensor and expressed in parts/billion (ppb).RESULTS:
The breath ammonia in healthy subjects had an average value of 151.4 ppb (95% confidence interval [CI] 149.4-153.4) and the average value in cirrhotic patients was 169.9 ppb (95% CI 163.5-176.2) (P < 0.0001). In cirrhotic patients with and without HE, the corresponding values were 184.1 ppb (95% CI 167.7-200.6) and 162.9 ppb (95% CI 158.8-167.0), respectively (P = 0.0011). Ammonia levels ≥ 165 ppb permitted a differentiation between healthy and cirrhotic subjects; the area under the receiver operating characteristic (ROC) curve for the ammonia-level values in cirrhotic versus control patients was 0.86 (95% CI 0.79-0.93). In cirrhotic patients, ammonia levels ≥ 175 ppb permitted the distinction between patients with and without HE; the area under the ROC curve in cirrhotic patients with versus without HE was 0.83 (95% CI 0.73-0.94).CONCLUSION:
A portable sensor for measuring breath ammonia can be developed. If the results of the present study are confirmed, breath-ammonia determinations could produce a significant impact on the care of patients with cirrhosis and could even include the possibility of self-monitoring.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Testes Respiratórios
/
Encefalopatia Hepática
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Amônia
/
Cirrose Hepática
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article