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Digestive Diseases and Sciences

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01-01-2012 | Original Article

Breath-Ammonia Testing of Healthy Subjects and Patients with Cirrhosis

Authors: R. Adrover, D. Cocozzella, E. Ridruejo, A. García, J. Rome, J. J. Podestá

Published in: Digestive Diseases and Sciences | Issue 1/2012

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 106 subjects: 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.

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Title: Breath-Ammonia Testing of Healthy Subjects and Patients with Cirrhosis
Authors: R. Adrover
D. Cocozzella
E. Ridruejo
A. García
J. Rome
J. J. Podestá
Publication date: 01-01-2012
Publisher: Springer US
Published in: Digestive Diseases and Sciences / Issue 1/2012
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI: https://doi.org/10.1007/s10620-011-1858-9

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Background

Aims

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