this arm will recieve PEG3350 in addition to standard of care

this arm will recieve only standard of care for management of hepatic encephlaopathy with ACLF

Hepatic Encephalopathy

Acute-On-Chronic Liver Failure

experimental arm will receive 2 doses of PEG3350 spaced over 12 hours after randomization to arm1. PEG as dose of 2litres (1 sachet dissolved in 2L of water) will be administered via a nasogastric tube.

PEG-3350 with Electolytes

Lactulose will be given orally (30ml QID) which shall be titrated to ensure 2-3 soft stools per day

Lactulose

Postgraduate Institute of Medical Education and Research

PEG3350 in ACLF With Hepatic Encephalopathy

Therapeutic Efficacy of Oral PEG3350 Plus Lactulose Versus Lactulose Alone in Patients of Acute on Chronic Liver Failure With Overt Hepatic Encephalopathy: A Single Blind Prospective Randomized Controlled Study

to look for any survival benefit in experimental arm at 28 days and 90 days

to look for the degree of improvement in grade of HE in both experimental arm and lactulose arm.

to extrapolate weather reduction of grade of HE correlates with reduction of ammonia levels

to analyse the difference in time to event(death) among non survivors in experimental arm

to look for any evidence of cerebral edema reduction by means of optic nerve sheath diameter

to analyse if reduction of HEresults in reduction or prevention of seizure episodes in both arms

Radha K Dhiman

Professor

participant is randomised using a table of random numbers.

Exercise Induced Hyponatremia

Gatorade Endurance Formula

GnRH antagonist, subcutaneous injection, 0.25 mg/day for 21 days.

hyponatremia/carbohydrate

PEG3350 in ACLF With Hepatic Encephalopathy

The Effects of Estradiol and Progesterone on Arginine Vasopressin Regulation and Serum Sodium Concentration

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