Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Whole-Body Hypothermia in Ammonia Intoxication: Effect on Monkeys With Portacaval Shunts

Whole-Body Hypothermia in Ammonia Intoxication: Effect on Monkeys With Portacaval Shunts Abstract Hepatic coma is a serious complication of advanced liver disease. It may occur secondary to hemorrhage from gastroesophageal varices, after operation for portal decompression, or in the final stages of hepatic decompensation. The prognosis varies with the severity of the underlying liver disease and the recuperative powers of the liver. Although the metabolic derangements associated with hepatic coma are not completely known, elevated levels of blood ammonia are found with reasonable consistency.1,2 This has been recognized since 1896 when Nencki and Pawlow3 related blood ammonia elevations with meat intoxication. McDermott and Adams,4 Mann et al,5 and Levine and Rigler6 showed that blood ammonia levels often rose after portacaval anastomosis. Protein digestion in the gastrointestinal tract is a major source of ammonia. The products of digestion, including ammonia, are absorbed and carried by the portal vein. The normal liver can readily detoxify ammonia by converting it References 1. Described in Reif8 and Natelson.9 2. Bessman, S. P., and Bessman, H. N.: The Cerebral and Peripheral Uptake of Ammonia in Liver Disease With an Hypothesis for the Mechanism of Hepatic Coma , J Clin Invest 34:622, 1955.Crossref 3. Pearlman, D. M.: The Effect of Glutamate Administration on Blood Ammonia Level and Its Correlation With Clinical Status in Patients With Hepatic Coma , Surg Forum 6:364, 1955. 4. Nencki, M., and Pawlow, J. P.: Arch Exp Path Pharmakol 32:161, 1896 5. 37:26, 1896 6. Folin, O., and Denis, W.: Protein Metabolism From the Standpoint of Blood and Time Analysis: II. The Origin and Significance of the Ammonia in Portal Blood , J Biol Chem 11:161, 1912. 7. McDermott, W. V., Jr., and Adams, R. D.: Episodic Stupor Associated With an Eck Fistula in the Human, With Particular Reference to the Metabolism of Ammonia , J Clin Invest 33:1, 1954.Crossref 8. Mann, J. D.; Bollman, J. L.; Huizenga, K. A.; Farror, T.; and Grindlay, J. H.: Blood Ammonia, Experimental and Clinical Study in Abnormalities of the Liver and Portal Circulation , Gastroenterology 27:399, 1954. 9. Levine, R. S., and Rigler, S. P.: Studies on the Ammonia Tolerance Curve in Dogs With Portacaval Shunts , Surg Forum 8:235, 1957. 10. Keirle, A. M.; McGloin, J. J.; Buben, R. W.; and Altemeier, W. A.: Blood Ammonia: Experimental and Clinical Reduction by Hypothermia , Arch Surg 83:348-355, 1961.Crossref 11. Reif, A. E.: The Ammonia Content of Blood and Plasma , Anal Biochem 1:351-370, 1960.Crossref 12. Natelson, S.: Microtechniques of Clinical Chemistry for the Routine Laboratory , Springfield, Ill: Charles C Thomas, Publisher, 1959, p 484. 13. Zuidema, G. D.; Gaisford, W. D.; Rakolta, G.; Fletcher, M. M.; Burton, W. D.; and Child, C. G., III: Comparative Blood Ammonia Studies in Dogs and Monkeys , Arch Surg 85:776-782, 1962.Crossref 14. Eiseman, B.; Owens, J. C.; and Swan, H.: Hypothermia in General Surgery , New Eng J Med 255:750, 1956.Crossref 15. Clauss, R. H.; Junker, R. D.; Browning, L. D.; and MacFee, W. F.: Hypothermia for Portacaval Shunts , Ann Surg 150:99, 1959.Crossref 16. Wotkyns, R. S.; Kirose, H.; and Eiseman, B.: Prolonged Hypothermia in Experimental Pneumococcal Peritonitis , Surg Gynec Obstet 107: 363, 1958. 17. Fedor, E. J.; Fisher, B.; and Fisher, E. R.: Observations Concerning Bacterial Defense Mechanisms During Hypothermia , Surgery 43:807, 1958. 18. Brauer, R. W.: " The Effect of Hypothermia on the Isolated Perfused Rat Liver ," in The Physiology of Induced Hypothermia: Proceedings of a Symposium, October 1955 , Division Medical Sciences, National Academy of Sciences, National Research Council, pp 235-242. 19. Welch, H. F.; Affifi, R.; and Rosano, C. L.: Effect of Hypothermia on Blood Ammonia Formation , Surgery 50:390-394, 1961. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Whole-Body Hypothermia in Ammonia Intoxication: Effect on Monkeys With Portacaval Shunts

Loading next page...
 
/lp/american-medical-association/whole-body-hypothermia-in-ammonia-intoxication-effect-on-monkeys-with-eggifQG5iT
Publisher
American Medical Association
Copyright
Copyright © 1963 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1963.01310160040007
Publisher site
See Article on Publisher Site

Abstract

Abstract Hepatic coma is a serious complication of advanced liver disease. It may occur secondary to hemorrhage from gastroesophageal varices, after operation for portal decompression, or in the final stages of hepatic decompensation. The prognosis varies with the severity of the underlying liver disease and the recuperative powers of the liver. Although the metabolic derangements associated with hepatic coma are not completely known, elevated levels of blood ammonia are found with reasonable consistency.1,2 This has been recognized since 1896 when Nencki and Pawlow3 related blood ammonia elevations with meat intoxication. McDermott and Adams,4 Mann et al,5 and Levine and Rigler6 showed that blood ammonia levels often rose after portacaval anastomosis. Protein digestion in the gastrointestinal tract is a major source of ammonia. The products of digestion, including ammonia, are absorbed and carried by the portal vein. The normal liver can readily detoxify ammonia by converting it References 1. Described in Reif8 and Natelson.9 2. Bessman, S. P., and Bessman, H. N.: The Cerebral and Peripheral Uptake of Ammonia in Liver Disease With an Hypothesis for the Mechanism of Hepatic Coma , J Clin Invest 34:622, 1955.Crossref 3. Pearlman, D. M.: The Effect of Glutamate Administration on Blood Ammonia Level and Its Correlation With Clinical Status in Patients With Hepatic Coma , Surg Forum 6:364, 1955. 4. Nencki, M., and Pawlow, J. P.: Arch Exp Path Pharmakol 32:161, 1896 5. 37:26, 1896 6. Folin, O., and Denis, W.: Protein Metabolism From the Standpoint of Blood and Time Analysis: II. The Origin and Significance of the Ammonia in Portal Blood , J Biol Chem 11:161, 1912. 7. McDermott, W. V., Jr., and Adams, R. D.: Episodic Stupor Associated With an Eck Fistula in the Human, With Particular Reference to the Metabolism of Ammonia , J Clin Invest 33:1, 1954.Crossref 8. Mann, J. D.; Bollman, J. L.; Huizenga, K. A.; Farror, T.; and Grindlay, J. H.: Blood Ammonia, Experimental and Clinical Study in Abnormalities of the Liver and Portal Circulation , Gastroenterology 27:399, 1954. 9. Levine, R. S., and Rigler, S. P.: Studies on the Ammonia Tolerance Curve in Dogs With Portacaval Shunts , Surg Forum 8:235, 1957. 10. Keirle, A. M.; McGloin, J. J.; Buben, R. W.; and Altemeier, W. A.: Blood Ammonia: Experimental and Clinical Reduction by Hypothermia , Arch Surg 83:348-355, 1961.Crossref 11. Reif, A. E.: The Ammonia Content of Blood and Plasma , Anal Biochem 1:351-370, 1960.Crossref 12. Natelson, S.: Microtechniques of Clinical Chemistry for the Routine Laboratory , Springfield, Ill: Charles C Thomas, Publisher, 1959, p 484. 13. Zuidema, G. D.; Gaisford, W. D.; Rakolta, G.; Fletcher, M. M.; Burton, W. D.; and Child, C. G., III: Comparative Blood Ammonia Studies in Dogs and Monkeys , Arch Surg 85:776-782, 1962.Crossref 14. Eiseman, B.; Owens, J. C.; and Swan, H.: Hypothermia in General Surgery , New Eng J Med 255:750, 1956.Crossref 15. Clauss, R. H.; Junker, R. D.; Browning, L. D.; and MacFee, W. F.: Hypothermia for Portacaval Shunts , Ann Surg 150:99, 1959.Crossref 16. Wotkyns, R. S.; Kirose, H.; and Eiseman, B.: Prolonged Hypothermia in Experimental Pneumococcal Peritonitis , Surg Gynec Obstet 107: 363, 1958. 17. Fedor, E. J.; Fisher, B.; and Fisher, E. R.: Observations Concerning Bacterial Defense Mechanisms During Hypothermia , Surgery 43:807, 1958. 18. Brauer, R. W.: " The Effect of Hypothermia on the Isolated Perfused Rat Liver ," in The Physiology of Induced Hypothermia: Proceedings of a Symposium, October 1955 , Division Medical Sciences, National Academy of Sciences, National Research Council, pp 235-242. 19. Welch, H. F.; Affifi, R.; and Rosano, C. L.: Effect of Hypothermia on Blood Ammonia Formation , Surgery 50:390-394, 1961.

Journal

Archives of SurgeryAmerican Medical Association

Published: Oct 1, 1963

References