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Experimentation in Eck-Fistula Dogs

GEORGE D. ZUIDEMA, MD; DAVID CULLEN; RICHARD S. KOWALCZYK, PhD; EARL F. WOLFMAN, JR., MD

AMA Arch Surg. 1963;87(2):296-300.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Introduction

Hepatic coma, a consequence of severe liver disease, is usually associated with elevated levels of blood ammonia and derangements of serum electrolytes and pH. Treatment of hepatic coma may be directed toward lowering of the blood ammonia level once this elevation has occurred or preventing the absorption of the products of protein digestion within the gastrointestinal tract.

Several methods have been employed to control blood ammonia. Neomycin is useful in removing urea-splitting organisms from the intestine, thereby limiting the amount of ammonia absorbed into the portal circulation.¹ The side effects of neomycin treatment, however, impair its usefulness. Hypothermia lowers blood ammonia, probably by limiting bacterial action.^2,3 Arginine and glutamic acid^4-6 enjoyed brief popularity because of the belief that they aided the metabolism of ammonia and its elimination via the Krebs urea cycle. Hemodialysis⁷ is effective in clearing the blood of ammonia, but the technique is . . . [Full Text PDF of this Article]

Author Affiliations
ANN ARBOR, MICH

John and Mary R. Markle Scholar in Academic Medicine, USPHS Career Development Awardee (Dr. Zuidema).; Department of Surgery, University of Michigan Medical School.

Footnotes
Presented at the 20th Annual Meeting of the Central Surgical Association, Chicago, Feb 21-23, 1963.

Supported in part by grants from the US Public Health Service, National Institute for Arthritis and Metabolic Disease H4260 (C-3), and Career Development Award AM K3-13,702; US Army Contract DA 49-007-MD-1016.

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