role of branch chain amino acids [aminoleban] in the management of hepatic encephalopathy

ABSTRACT

To find out the efficacy of branch chain amino acids [Aminoleban] in the reversal / improvement of hepatic encephalopathy due to chronic liver disease [CLD] presenting with grade 3 and 4 hepatic coma. This descriptive study was carried out at the Department of Medicine, Saidu Teaching Hospital, Swat from 1st July 2005 to 31st December 2005. Patients meeting the criteria were enrolled by nonprobability convenient sampling method. Aminoleban was administered, transfusing two consecutive infusions [500 ml each] daily for 3 consecutive days only. The changes in the mental state were evaluated on day 1, 2 and 3 following Aminoleban therapy. A total of 50 patients [30 males and 20 females] with mean age of 51.3 years were recruited. The duration of CLD was 1-2 years in 25 patients [50%], 2-5 years in 15 patients [30%] and >5 years in 10 patients [20%]. Forty patients [80%] had first episode of hepatic encephalopathy. Complete reversal of hepatic encephalopathy was observed in 25 patients [50%] at end of 3rd day and there was no change in the grade of the coma in 15 patients [30%]. Grade of coma aggravated in 10 [20%] patients. Majority of non-responders [n=10] were having >5 years of duration of CLD. The parentral use of branch chain amino acids [Aminoleban] is reasonably effective treatment modality in the reversal of first episode of hepatic encephalopathy especially with shorter duration of CLD