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Hyperammonemia Neonatal Disease Scholarly Peer Review Journal | Open Access Journals
Journal of Nursing & Care

Journal of Nursing & Care

ISSN: 2167-1168

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Hyperammonemia Neonatal Disease Scholarly Peer Review Journal

Hyperammonemia is usually defined as a plasmatic level above 80 µmol/L in infants up to 1 month of age and above 55 µmol/L in older children.1 Hyperammonemia is an acute life-threatening condition that can lead to severe neurologic impairment and cerebral edema. The most common causes of hyperammonemia in children are severe liver failure and inherited metabolic diseases.

Acute hyperammonemia can induce neurological damage leading to an acute life-threatening condition. The duration of the coma, the peak of ammonia and the duration of hyperammonemia are the main risk factors for neurological deficits linked to hyperammonemia and death. In children, hyperammonemia is mainly caused by severe liver failure and innate errors of metabolism. In an acute setting, obtaining reliable plasma ammonia levels can be difficult due to the pre-analytical difficulties which must be treated with care. The management of hyperammonemia includes 1) the identification of precipitating factors and the presence of cerebral edema, 2) a decrease in ammonia production by reducing protein intake and reversing catabolism, and 3) elimination of ammonia with pharmacological treatment and, in the most serious cases, with extracorporeal therapies. In severe coma, transcranial Doppler ultrasound may be the method of choice for non-invasively monitoring cerebral blood flow and titrating therapies.

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