Introduction: Hepatic encephalopathy is defined as a spectrum of neuropsychiatric abnormalities in patients with liver dysfunction after exclusion of brain disease. To compare arterial vs venous ammonia levels in hepatic encephalopathy and to correlate the severity of hepatic encephalopathy with arterial as well as venous ammonia levels. Materials and methods: This study was an observational study conducted on 60 patients of hepatic encephalopathy admitted to a tertiary care hospital and medical institute. For ammonia estimation, arterial and venous samples were collected on first, third, and fifth days of admission. The samples were then centrifuged immediately and analyzed with in 30 minutes of centrifugation on fully automated analyzer by Siemens RxL Dimensions. Patients were thoroughly examined to know the grade of hepatic encephalopathy. Then, arterial and venous ammonia levels were correlated with the severity of hepatic encephalopathy. Results: Arterial ammonia level measurement is considered better while assessing hepatic encephalopathy when compared with venous ammonia levels. Results of this study also indicated that arterial total ammonia level measurement is a better indicator in assessing the grade of hepatic encephalopathy when compared with venous total ammonia levels. Of all patients, most were in grade I, and the highest level of ammonia was seen in grades III and IV. Conclusion: Arterial ammonia levels correlated better with the presence and severity of hepatic encephalopathy when compared with venous ammonia levels.
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