Measurement of the Expiratory Ammonia Concentration and its Clinical Significance |
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| Authors: | Wakabayashi Hiroyuki Kuwabara Yoshihiro Murata Hiroyuki Kobashi Kyoich Watanabe Akiharu |
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| Institution: | (1) Department of Biological Chemistry, Faculty of Pharmaceutical Science, Toyama Medical and Pharmaceutical University, Toyama, Japan;(2) The Third Department of Internal Medicine, Faculty of Medicine, Toyama Medical and Pharmaceutical University, 2630 Sugitani, 930-01 Toyama, Japan |
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| Abstract: | Alghough gaseous ammonia (NH3) can freely enter cells through the plasma membrane where NH3 is cyto(neuro)toxic, NH3 and ionic ammonia (NH4
+) contents have not been studied in biological materials. We developed a new method for measurement of expiratory NH3 concentration, which may reflect blood NH3 concentrations. The method is a sensor tube type-gas assay system. Expiratory NH3 concentrations in patients with chronic liver diseases increased when their blood ammonia (NH4
++NH3) concentrations increased above 90 μg/dl (normal range; 12–66 μg/dl). However, cirrhotic patients, who had relatively higher
expiratory NH3 concentration compared to blood NH3 concentrations (calculated from Henderson-Hasselbalch formula), were found to have subclinical encephalopathy. Measurement
of experatory NH3 concentration may be of clinical significance for the diagnosis of encephalopathy associated with hyperammonemia. |
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| Keywords: | Ammonia NH4 + gaseous ammonia expiratory air hepatic encephalopathy liver cirrhosis |
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