Role of Branched Chain Amino Acids in Reversal of Hepatic Encephalopathy

Objective: The objective of this study was to determine the effect of branched chain amino acids on reversal of hepatic encephalopathy. The reversal of hepatic encephalopathy was determined by time required for improvement in grade of encephalopathy and total duration of hospital stay. Study Design: Single blinded Randomized Control Clinical Trial. Setting and Duration: In the Gastroenterology Unit, Medical-1 Allied Hospital Faisalabad. Duration of the study was one year, started in May 2005. Patients and Methods: Hundred cases of hepatic encephalopathy grade IV were divided in two groups of fifty each. It was random allocation of two group. After taking informed consent, group I and II, both were given standard treatment and group II received branched chain amino acids. Results: Complete record of all the patients was maintained on the proforma and kept confidential. Six patients in group I and four patients in group II died during the study duration. 11 subjects in group 1 as compared to 26 in group II showed improvement in maximum duration of less than 3 days. (p < 0.05). 25 cases in group I and 9 in group II showed significant improvement in nine or more days. (p < 0.05). On comparison of duration of hospital stay 19 cases in group I as compared to 37 in group II showed hospital stay less than nine days (p < 0.05). Conclusions: There is a role of branched chain amino acids in early reversal of hepatic encephalopathy due to chronic liver disease. However further Randomized Clinical Trials are required.