Episode 96: Understanding ammonia, with Prem Kandiah

In this episode of Critical Care Scenarios, Brandon Odo interviews Dr. Prem Kandiah, a neurointensivist, about hyperammonemia. They discuss the physiology of ammonia production and detoxification, its toxicity to the brain, and the clinical utility of measuring ammonia levels in different scenarios such as in cirrhotic patients, acute liver failure, and patients with altered mental status. They explore various causes of hyperammonemia beyond liver disease, including infections, nutritional deficiencies, and metabolic dysfunctions, and discuss treatment strategies, including nutritional support, and dialysis, while emphasizing the importance of addressing the underlying causes and potential pitfalls in management.