Hyperammonemia as an Adverse Effect in Parenteral Nutrition

Devasahayam, Joe; John, Santhosh; Assar, Seth; Bhat, Zeenat; Kurup, Aparna Narayana; Hosuru, Suresh; Joseph, Valentina; Pillai, Unnikrishnan

doi:10.1007/978-1-4614-8503-2_159-1

Cited by 3 publications

(1 citation statement)

References 48 publications

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“…Earlier research has linked PN, particularly the amino acid component, to hyperammonemia, thus prompting a recommendation to restrict or avoid PN. Much of the literature guiding this recommendation originates from older case reports of infants or inborn UCDs which are rare in this population [1,5,[49][50][51][52][53][54]. Furthermore, many of these cases were reported during a time when common practice was to provide much higher amounts of amino acids than what is recommended today, possibly indicating that the hyperammonemia observed was simply a result of overfeeding amino acids in excess of physiologic demand.…”

Section: Parenteral Nutritionmentioning

confidence: 99%

Treatment of Hyperammonemia Syndrome in Lung Transplant Recipients

Yun,

Scalia,

Farghaly

2023

JCM

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Hyperammonemia syndrome is a complication that has been reported to occur in 1–4% of lung transplant patients with mortality rates as high as 60–80%, making detection and management crucial components of post-transplant care. Patients are treated with a multimodal strategy that may include renal replacement therapy, bowel decontamination, supplementation of urea cycle intermediates, nitrogen scavengers, antibiotics against Mollicutes, protein restriction, and restriction of parenteral nutrition. In this review we provide a framework of pharmacologic mechanisms, medication doses, adverse effects, and available evidence for commonly used treatments to consider when initiating therapy. In the absence of evidence for individual strategies and conclusive knowledge of the causes of hyperammonemia syndrome, clinicians should continue to design multimodal regimens based on suspected etiologies, institutional drug availability, patient ability to tolerate enteral medications and nutrition, and availability of intravenous access.

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