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HERO ID
990523
Reference Type
Journal Article
Title
Branched chain amino acids supplemented with L-acetylcarnitine versus BCAA treatment in hepatic coma: a randomized and controlled double blind study
Author(s)
Malaguarnera, M; Risino, C; Cammalleri, L; Malaguarnera, L; Astuto, M; Vecchio, I; Rampello, L
Year
2009
Is Peer Reviewed?
Yes
Journal
European Journal of Gastroenterology and Hepatology
ISSN:
0954-691X
EISSN:
1473-5687
Volume
21
Issue
7
Page Numbers
762-770
Language
English
PMID
19357525
DOI
10.1097/MEG.0b013e328309c791
Abstract
OBJECTIVE:
Our earlier study has demonstrated that the administration of L-acetylcarnitine (LAC) improves neurological symptoms and serum parameters in hepatic coma. The aim of this work has been to evaluate the efficacy of the LAC and branched chain amino acids (BCAA) versus BCAA, administered in intravenous infusion, in patients with cirrhotic hepatic coma.
METHODS:
Forty-eight highly selected patients were enrolled in the study and, after randomization, received blindly LAC+BCAA (n=24) versus BCAA (n=24). The two groups were similar in age, sex, pathogenesis of cirrhosis, and severity of liver disease. The comparison between values before and after LAC planned treatment showed statistical significant differences in neurological findings, evaluated by the Glasgow Scale, ammonia serum levels, blood urea nitrogen, and EEG.
RESULTS:
After 60 min of the study period, the LAC+BCAA treated patients compared with BCCA treated showed a significant decrease of ammonia serum levels: 41.20 versus 10.40 mumol P<0.05. After 1 day of the study period, the LAC+BCAA treated patients compared with BCCA treated patients showed a significant increase of Glasgow's score: 3.60 versus 1.50 score P<0.05; a significant decrease of ammonia serum levels: 63.30 versus 27.00 mumol P<0.01; a significant improvement of EEG cps/s: 2.70 versus 0.6 P<0.001. No side-effects were observed in our study series.
CONCLUSION:
Our study demonstrated that the administration of BCAA supplemented with LAC might improve neurological symptoms and serum ammonium levels in selected cirrhotic patients with hepatic coma.
Tags
IRIS
•
Ammonia
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