THE EFFECT OF SODIUM GLUTAMATE ON HEPATIC COMA 12

Abstract

A maximum of 23 g of intravenous sodium glutamate daily had no beneficial clinical effect on spontaneous impending coma or hepatic coma of 7 patients with cirrhosis. It also failed to prevent the onset or exacerbation of impending coma induced by ammonium salts given 2 patients with cirrhosis. Fourteen to 18 hours following glutamate injection peripheral venous plasma NH3-N concentrations or electrolytes showed no consistent changes in the above group. Only temporary clinical improvement in 3 comatose cirrhotic patients occurred during administration of large quantities (103-355 g over 17-93 hours) of continuous intravenous sodium glutamate. Death ensued although venous blood NH3-N concentrations became or remained normal. The principal complication was the development of hypokalemic alkalosis resulting mainly from the large amounts of Na given.