https://www.cghjournal.org/article/S1542-3565(24)00219-2/fulltext
In conclusion, these findings in hospitalized patients with cirrhosis and OHE reveal no apparent relationship between serum ammonia levels and OHE severity or time to OHE resolution. Although these analyses were limited by the small number of patients included who had ammonia levels tested on day 1, the findings are consistent with data suggesting no relationship between baseline ammonia levels and time to resolution of OHE. The extension of this finding to the setting of a randomized controlled trial further supports the lack of utility for ammonia as a diagnostic tool in OHE.2 These data, along with evidence that ammonia testing has been shown to have low diagnostic accuracy in patients with cirrhosis and OHE,8 warrant implementation of educational initiatives and/or tools that address and mitigate the overutilization of ammonia testing in select clinical settings.3