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Ammonia!

This test has such a big footprint in the landscape of liver disease management. But it is just too complicated to deserve its spotlight

Reposting this #tweetorial

NH3 levels:
1⃣a potent biomarker of illness
2⃣unreliable
3⃣only part of the HE story
#livertwitter
Since I posted this tweetorial:

1. ISHEN released a consensus, touching on NH3. pubmed.ncbi.nlm.nih.gov/32224704/?from…. This features the fig below
2. A major publication on the variability and lability of Nh3 levels from @JasmohanBajaj @BloomPringle @AmCollegeGastro #amjgastro #livertwitter

ncbi.nlm.nih.gov/pmc/articles/P…
3. A great study on the clinical utility of Nh3 levels in #amjgastro that I had the privilege to editorialize with Bob Rahimi. Order them or not, high or low: it just doesnt change management

Paper: insights.ovid.com/pubmed?pmid=31…
Editorial: insights.ovid.com/pubmed?pmid=31…
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