THEammoniémiehe ho'āʻo e ana i ka nui oamonia i loko o ke koko.

He kuleana ko Ammonia mālama pH akā, he mea ʻawaʻawa ia e hoʻololi koke ʻia a hoʻopau ʻia. Inā loaʻa i ka nui (hyperammoniémie), he mea ʻawaʻawa loa ia i ka lolo a hiki ke huikau (nā maʻi psychiatric), lethargy a i kekahi manawa he koma.

Loaʻa kona synthesis i loko o kaʻōpū, akā ma ka pae renal a me muscular. Hana ʻia kona detoxification i loko o ke akepaʻa kahi i hoʻololi ʻia i urea, a laila hoʻopau ʻia i kēia ʻano i ka mimi.

No ka mea he mea ʻawaʻawa kēia, he mea nui ia e hana i kahi hōʻike ammonia ke manaʻo ʻoe i ka piʻi ʻana o kona ʻike.

Hiki i ke kauka ke kuhikuhi i kona dosage:

• ina ua hoohuoi a Hepatic lawa ʻole

• e ʻimi i nā kumu o ka ʻike ʻole a i ʻole ka hoʻololi ʻana i ke ʻano

• e ʻike i nā kumu o kahi coma (a laila kuhikuhi ʻia me nā hoʻāʻo ʻē aʻe, e like me ke koko koko, ka ate a me ka loiloi o ka hana ʻāʻī, nā electrolytes)

• e nānā i ka maikaʻi o ka mālama ʻana no ka encephalopathy hepatic (ka hoʻopilikia ʻana i ka hana noʻonoʻo, ka hana neuromuscular a me ka ʻike e kū mai ana ma muli o ka pau ʻole o ka hepatic acute)

E hoʻomaopopo he hiki i ke kauka ke noi i ka amonia i loko o kahi keiki hānau hou inā lilo ʻo ia i mea huhū, luaʻi, a hōʻike paha i ka luhi nui i nā lā mua o kona hānau ʻana. Hoʻokō pono ʻia kēia dosage i ka wā o ka haukapila.

Hiki ke hoʻoholo ʻia ka ammonia ma nā ʻano like ʻole:

• by hōʻike koko ʻaʻa, hana ʻia ma ke aʻaʻa femoral (ma ka ʻāʻī o ka ʻāʻī) a i ʻole ke aʻa radial (ma ka pulima)

• e ka laʻana koko venous, lawe pinepine ʻia ma ka piko o ka kuʻekuʻe, ʻoi aku ka maikaʻi ma ka ʻōpū ʻole

ʻO nā waiwai maʻamau no ka amonia i nā pākeke ma waena o 10 a me 50 µmoles / L (micromoles per lita) i ke koko arterial.

ʻOkoʻa kēia mau waiwai ma muli o ka laʻana akā aia nō hoʻi ma ka hale hana e hana ana i ka nānā ʻana. He haʻahaʻa iki lākou i ke koko venous ma mua o ke koko arterial. Hiki iā lākou ke ʻokoʻa ma muli o ke kāne a ʻoi aku ka kiʻekiʻe o nā keiki hānau hou.

Inā hōʻike nā hopena i kahi kiʻekiʻe o ka amonia (hyperammonemia), ʻo ia ka mea ʻaʻole hiki i ke kino ke wāwahi iā ia a hoʻopau iā ia. Hiki ke hoʻohui pū ʻia kahi helu kiʻekiʻe me:

• ka hanu pale

• pōʻino o ka ate a i ʻole ka puʻupaʻa

• hypokalemia (ka pae haʻahaʻa o ka potassium i loko o ke koko)

• naau ole

• kahe koko gastrointestinal

• he maʻi genetic e pili ana i kekahi mau mea o ka pōʻai urea

• ʻehaʻeha ʻiʻo nui
• ʻona (lāʻau antiepileptic a i ʻole phalloid amanitis)

Hiki ke kuhikuhi ʻia kahi meaʻai haʻahaʻa-protein (haʻahaʻa i ka ʻiʻo a me ka protein) a me nā lāʻau lapaʻau (arginine, citrulline) e kōkua ana i ka hoʻopau ʻana i ka amonia.