Comparison of polyethylene glycol 3350 electrolyte solution and lactulose in patients with overt hepatic encephalopathy: A retrospective study from a tertiary care hospital
Background: Hepatic encephalopathy (HE) is a brain dysfunction caused by liver failure and/or porto-systemic shunt and it manifests as a wide spectrum of neurological or psychiatric abnormalities. The aim of the study was to evaluate if polyethylene glycol (PEG) is more effective than lactulose in r...
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KIMS Foundation and Research Center
2022-10-01
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| Series: | Journal of Medical and Scientific Research |
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| Online Access: | http://jmsronline.com/archive-article/polyethylene-glycol-3350-electrolyte-lactulose-hepatic-encephalopathy |
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| author | Beg MA Mushtaq M Andrabi SS Mir IS Gulzar GM Zargar SA |
| author_facet | Beg MA Mushtaq M Andrabi SS Mir IS Gulzar GM Zargar SA |
| author_sort | Beg MA |
| collection | DOAJ |
| description | Background: Hepatic encephalopathy (HE) is a brain dysfunction caused by liver failure and/or porto-systemic shunt and it manifests as a wide spectrum of neurological or psychiatric abnormalities. The aim of the study was to evaluate if polyethylene glycol (PEG) is more effective than lactulose in resolution of encephalopathy and determine if it decreases the hospital stay.
Material and methods: Retrospectively from hospital records we selected 80 patients with hepatic encephalopathy (HE) due to underlying cirrhosis of liver. Forty (40) patients were taken from the group who were treated with lactulose and based on age matching (± 2 years) and encephalopathy grade matching (±1 grade) 40 patients were selected from the group who were treated with PEG. Grading of HE was determined by using hepatic encephalopathy scoring algorithm (HESA) and West Haven (WH) criteria. Resolution of HE was defined as improvement in HESA/West Haven score to grade 0, patient discharge or 2 consecutive days when HESA grade remained at 1 after an initial improvement of at least 1 full grade.
Results: The mean age of PEG group was similar to lactulose group (58.2 ± 10.11 vs 58.70 ± 9.54 years; p = 0.829) with a male predominance in both groups. All patients were of Child Turcot Pugh (CTP) class C with a mean MELD score of 18.7±5.42 vs 18.9±4.75 in PEG group and lactulose group respectively (p = 0.827). The time taken for complete resolution of HE was also lesser in PEG group compared to lactulose group with a significant p value of <0.001.
Conclusions: PEG therapy significantly improved the overall grade of encephalopathy in first 24 hours and reduced days to complete resolution of hepatic encephalopathy. |
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| language | English |
| last_indexed | 2024-04-11T04:30:17Z |
| publishDate | 2022-10-01 |
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| spelling | doaj.art-4ff9f34427584f169ece918916ee12b22022-12-29T09:42:02ZengKIMS Foundation and Research CenterJournal of Medical and Scientific Research2321-13262394-112X2022-10-0110420621110.17727/JMSR.2022/10-38Comparison of polyethylene glycol 3350 electrolyte solution and lactulose in patients with overt hepatic encephalopathy: A retrospective study from a tertiary care hospitalBeg MA0Mushtaq M1Andrabi SS2Mir IS3Gulzar GM4Zargar SA5Department of Medicine, Government Medical College, Anantnag, Jammu and Kashmir- 192210, India Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir-190010, India Kumudini Women's Medical College, Mirzapur 1940, Bangladesh Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir-190010, India Department of Medical Gastroenterology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir-190011, India Department of Medical Gastroenterology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir-190011, India Background: Hepatic encephalopathy (HE) is a brain dysfunction caused by liver failure and/or porto-systemic shunt and it manifests as a wide spectrum of neurological or psychiatric abnormalities. The aim of the study was to evaluate if polyethylene glycol (PEG) is more effective than lactulose in resolution of encephalopathy and determine if it decreases the hospital stay. Material and methods: Retrospectively from hospital records we selected 80 patients with hepatic encephalopathy (HE) due to underlying cirrhosis of liver. Forty (40) patients were taken from the group who were treated with lactulose and based on age matching (± 2 years) and encephalopathy grade matching (±1 grade) 40 patients were selected from the group who were treated with PEG. Grading of HE was determined by using hepatic encephalopathy scoring algorithm (HESA) and West Haven (WH) criteria. Resolution of HE was defined as improvement in HESA/West Haven score to grade 0, patient discharge or 2 consecutive days when HESA grade remained at 1 after an initial improvement of at least 1 full grade. Results: The mean age of PEG group was similar to lactulose group (58.2 ± 10.11 vs 58.70 ± 9.54 years; p = 0.829) with a male predominance in both groups. All patients were of Child Turcot Pugh (CTP) class C with a mean MELD score of 18.7±5.42 vs 18.9±4.75 in PEG group and lactulose group respectively (p = 0.827). The time taken for complete resolution of HE was also lesser in PEG group compared to lactulose group with a significant p value of <0.001. Conclusions: PEG therapy significantly improved the overall grade of encephalopathy in first 24 hours and reduced days to complete resolution of hepatic encephalopathy. http://jmsronline.com/archive-article/polyethylene-glycol-3350-electrolyte-lactulose-hepatic-encephalopathyhepatic encephalopathycirrhosislactulosepolyethylene glycol |
| spellingShingle | Beg MA Mushtaq M Andrabi SS Mir IS Gulzar GM Zargar SA Comparison of polyethylene glycol 3350 electrolyte solution and lactulose in patients with overt hepatic encephalopathy: A retrospective study from a tertiary care hospital Journal of Medical and Scientific Research hepatic encephalopathy cirrhosis lactulose polyethylene glycol |
| title | Comparison of polyethylene glycol 3350 electrolyte solution and lactulose in patients with overt hepatic encephalopathy: A retrospective study from a tertiary care hospital |
| title_full | Comparison of polyethylene glycol 3350 electrolyte solution and lactulose in patients with overt hepatic encephalopathy: A retrospective study from a tertiary care hospital |
| title_fullStr | Comparison of polyethylene glycol 3350 electrolyte solution and lactulose in patients with overt hepatic encephalopathy: A retrospective study from a tertiary care hospital |
| title_full_unstemmed | Comparison of polyethylene glycol 3350 electrolyte solution and lactulose in patients with overt hepatic encephalopathy: A retrospective study from a tertiary care hospital |
| title_short | Comparison of polyethylene glycol 3350 electrolyte solution and lactulose in patients with overt hepatic encephalopathy: A retrospective study from a tertiary care hospital |
| title_sort | comparison of polyethylene glycol 3350 electrolyte solution and lactulose in patients with overt hepatic encephalopathy a retrospective study from a tertiary care hospital |
| topic | hepatic encephalopathy cirrhosis lactulose polyethylene glycol |
| url | http://jmsronline.com/archive-article/polyethylene-glycol-3350-electrolyte-lactulose-hepatic-encephalopathy |
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