Форма документа : Стаття із журналу Шифр видання : Автор(и) : Matthew Boyko, Kutz R., Grinshpun J., Zvenigorodsky V., Amit, Brotfain E., Melamed I., Frank D., Dubilet M., Netanel D., Zeldetz V., Zlotnik A. Назва : Hepatic encephalopathy: a look Glutamate system Місце публікування : Клінічна анестезіологія та інтенсивна терапія. - О., 2017. - № 1. - С. 89-97 (Шифр КУ51/2017/1) Примітки : Библиогр. в конце ст. MeSH-головна: ЭНЦЕФАЛОПАТИЯ ПЕЧЕНОЧНАЯ -- HEPATIC ENCEPHALOPATHY ПЕЧЕНОЧНАЯ НЕДОСТАТОЧНОСТЬ ОСТРАЯ -- LIVER FAILURE, ACUTE РЕЦЕПТОРЫ ГЛУТАМАТА -- RECEPTORS, GLUTAMATE Анотація: Hepatic encephalopathy (HE) is a neuropsychiatric syndrome which is associated with liver dysfunction and has quantitatively and qualitatively distinct features relating to its severity. It defines the prognosis in acute liver injury in which up to 30 % of patients succumb from brain herniation due to brain oedema and intracranial hypertension. In cirrhosis (chronic liver dysfunction), it occurs more insidiously causing a range of neuropsychiatric disturbances which include psychomotor dysfunction, impaired memory, increased reaction time, sensory abnormalities and poor concentration. In its most severe forms, patients may develop confusion, stupor, coma and death. In minimal HE, the changes in mental function are subtle and may be observed in patients with no overt clinical evidence of encephalopathy. The neuropsychological features of minimal HE are suggestive of a disorder of executive functioning. This primarily affects selective attention and psychomotor speed, which has a huge impact on health-related quality of life and has been shown to reduce the ability to drive. Acute-on-chronic liver failure defines a group of patients that have chronic liver disease and in these patients a severe precipitating event such as sepsis, gastrointestinal bleeding (increased ammonia load) or the creation of portosystemic shunting (increased ammonia load) provides a pathophysiologic framework in which the patients with a chronic ‘phenotype’ can appear clinically indistinct from those with acute liver failure Дод.точки доступу: Matthew, Boyko Kutz, R. Grinshpun, J. Zvenigorodsky, V. Amit Brotfain, E. Melamed, I. Frank, D. Dubilet, M. Netanel, D. Zeldetz, V. Zlotnik, A.