How to Cope with Neonatal Hyperammonemic Coma?

The following 9 tips may be helpful:
1.Protein intake should be stopped.
2.Calories should be supplied by giving hypertonic 10% glucose.
3.Hemodialysis should be started promptly in all comatose neonates with plasma ammonium levels greater than 10 times reference range. 4.Plasma ammonium levels are reduced quickly and the total dialysis time is shorter with hemodialysis than with peritoneal dialysis. 5.Continuous arteriovenous or venovenous hemofiltration may be used as an alternative method. [27]
6.Intravenous sodium benzoate and phenylacetate should be started once the plasma ammonium level falls to 3-4 times the upper limit of the reference range.
7.Intravenous arginine should be provided.
8.Corticosteroids are not indicated for the management of increased intracranial pressure in hyperammonemia because they induce negative nitrogen balance. Mannitol is not effective in treating cerebral edema induced by hyperammonemia.
9.Valproic acid should not be used to treat seizures as it decreases urea cycle function and increases serum ammonia levels.

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.