Document Detail


Emergency treatment of neonatal hyperammonaemic coma with mild systemic hypothermia.
MedLine Citation:
PMID:  11454378     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
An infant aged 3 days presented with hyperammonaemic coma and seizures, which were found to be a result of a urea-cycle defect. Haemofiltration, alternative pathway metabolites, and glucose and insulin failed to lower the plasma ammonia concentration below 2000 micromol/L. The infant was then cooled to a rectal temperature of 34 degrees C for 48 h and put on haemofiltration for 12 h. Plasma ammonia fell to around 100 micromol/L and remained at this concentration after haemofiltration. He roused from his coma, breathed spontaneously, and resumed bottle feeding. Hypothermia may be therapeutic in such instances of metabolic coma because it lowers the enzymatic rate of production of the toxin while non-enzymatic methods remove the toxin.
Authors:
A Whitelaw; S Bridges; A Leaf; D Evans
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Publication Detail:
Type:  Case Reports; Letter    
Journal Detail:
Title:  Lancet     Volume:  358     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-07-16     Completed Date:  2001-07-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  England    
Other Details:
Languages:  eng     Pagination:  36-8     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Ammonia / blood
Carbamoyl-Phosphate Synthase (Ammonia) / deficiency,  genetics
Coma / genetics,  therapy*
Electroencephalography
Emergencies*
Hemofiltration*
Humans
Hyperammonemia / genetics,  therapy*
Hyperthermia, Induced*
Infant, Newborn
Male
Treatment Outcome
Chemical
Reg. No./Substance:
7664-41-7/Ammonia; EC 6.3.4.16/Carbamoyl-Phosphate Synthase (Ammonia)
Comments/Corrections
Comment In:
Lancet. 2001 Nov 17;358(9294):1727-8   [PMID:  11728574 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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