Evaluate for suspected underlying etiology as above and/or alternate etiology of presenting symptoms (e.g. workup for other causes of AMS)
Normal range of ammonia in adult is typically 10-80 mcg/dL or 6-47 μmol/L, <100 in neonate, HOWEVER severity of hepatic encephalopathy is inconsistently correlated to severity of ammonia elevation
Value of ammonia level in liver disease more helpful to trend rather than as absolute number
Value of ammonia level in liver disease more helpful to trend rather than as absolute number
Hyperammonemia
Liver failure
Ketonemia
Inborn errors of metabolism with urea cycle defects and organic acidemia
Lactic acidosis
Shock, severe dehydration
Ketoacidosis
Renal failure