Type A: Rapidly progresses to seizures, decerebrate rigidity, coma, and frequently death from cerebral edema.
Type B and C are chronic conditions that may manifest as minima...
Patients with grade 3 or 4 HE may require intubation for airway protection. Propofol is the preferred agent for sedation.
HE grade 2, 3, or 4 or inadequate social support
Type A HE (any grade) and type B or C (grade 2 or above) should be admitted to the ICU with urgent GI consult
Consider rifaximin for lactulose-resistant HE
Hypoglycemia is common in HE patients.
Avoid sedatives and narcotics if possible in HE patients. If necessary, use medications not metab...
Eroglu Y, Byrne WJ. Hepatic encephalopathy. Emerg Med Clin North Am. 2009;27(3):401–414.
Khungar V, Poordad F. Hepatic Encephalopathy. Clin Liv Dis. 2012;16:301–320.
070.6 Unspecified viral hepatitis with hepatic coma
070.9 Unspecified viral hepatitis without mention of hepatic coma
572.2 Hepatic encephalopathy
B19.0 Unspecified viral hepatitis with he...
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