{"id":"https://openalex.org/W7124299002","doi":"https://doi.org/10.14744/hf.2025.58807","title":"Use of albumin in patients with hepatic encephalopathy: A systematic review and meta-analysis of randomized controlled studies with trial sequential analysis","display_name":"Use of albumin in patients with hepatic encephalopathy: A systematic review and meta-analysis of randomized controlled studies with trial sequential analysis","publication_year":2026,"publication_date":"2026-01-01","ids":{"openalex":"https://openalex.org/W7124299002","doi":"https://doi.org/10.14744/hf.2025.58807","pmid":"https://pubmed.ncbi.nlm.nih.gov/41589201","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/12831988"},"language":"en","primary_location":{"id":"doi:10.14744/hf.2025.58807","doi":"https://doi.org/10.14744/hf.2025.58807","is_oa":true,"landing_page_url":"https://doi.org/10.14744/hf.2025.58807","pdf_url":"https://hepatologyforum.org/storage/upload/pdfs/1768477734-en.pdf","source":{"id":"https://openalex.org/S4210219018","display_name":"Hepatology forum/Hepatology forum (Online)","issn_l":"2757-7392","issn":["2757-7392","1307-5888"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","poland-20","russia-white-list-4","tr-dizin"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Hepatology Forum","raw_type":"journal-article"},"volume":null,"type":"review","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"bronze","oa_url":"https://hepatologyforum.org/storage/upload/pdfs/1768477734-en.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5104209044","display_name":"Ana Carolina Covre Coan","orcid":"https://orcid.org/0009-0001-4007-6670","observed_orcids":["https://orcid.org/0009-0001-4007-6670"]},"institutions":[{"id":"https://openalex.org/I51235708","display_name":"Universidade Federal do Esp\u00edrito Santo","ror":"https://ror.org/05sxf4h28","country_code":"BR","type":"education","lineage":["https://openalex.org/I51235708"]}],"countries":["BR"],"is_corresponding":true,"raw_author_name":"Ana Carolina Covre Coan","raw_affiliation_strings":["Department of Pediatric Neurology, School of Medicine, Federal University of Esp\u00edrito Santo, Brazil"],"raw_orcid":"https://orcid.org/0009-0001-4007-6670","affiliations":[{"raw_affiliation_string":"Department of Pediatric Neurology, School of Medicine, Federal University of Esp\u00edrito Santo, Brazil","institution_ids":["https://openalex.org/I51235708"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5095690139","display_name":"V\u00e2nio Antunes","orcid":"https://orcid.org/0009-0007-1127-230X","observed_orcids":["https://orcid.org/0009-0007-1127-230X"]},"institutions":[{"id":"https://openalex.org/I134363262","display_name":"Universidade Federal de Ci\u00eancias da Sa\u00fade de Porto Alegre","ror":"https://ror.org/00x0nkm13","country_code":"BR","type":"education","lineage":["https://openalex.org/I134363262"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Vanio Antunes do Livramento Junior","raw_affiliation_strings":["School of Medicine, Porto Alegre Health Sciences Federal University, Porto Alegre, Brazil"],"raw_orcid":"https://orcid.org/0009-0007-1127-230X","affiliations":[{"raw_affiliation_string":"School of Medicine, Porto Alegre Health Sciences Federal University, Porto Alegre, Brazil","institution_ids":["https://openalex.org/I134363262"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5108243311","display_name":"Alonzo Armani Prata","orcid":"https://orcid.org/0009-0009-3040-8772","observed_orcids":["https://orcid.org/0009-0009-3040-8772"]},"institutions":[{"id":"https://openalex.org/I51235708","display_name":"Universidade Federal do Esp\u00edrito Santo","ror":"https://ror.org/05sxf4h28","country_code":"BR","type":"education","lineage":["https://openalex.org/I51235708"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Alonzo Armani Prata","raw_affiliation_strings":["Department of Pediatric Neurology, School of Medicine, Federal University of Esp\u00edrito Santo, Brazil"],"raw_orcid":"https://orcid.org/0009-0009-3040-8772","affiliations":[{"raw_affiliation_string":"Department of Pediatric Neurology, School of Medicine, Federal University of Esp\u00edrito Santo, Brazil","institution_ids":["https://openalex.org/I51235708"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5100205607","display_name":"Nat\u00e1lia Junkes Milioli","orcid":"https://orcid.org/0000-0001-5424-2118","observed_orcids":["https://orcid.org/0000-0001-5424-2118"]},"institutions":[{"id":"https://openalex.org/I45643870","display_name":"Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul","ror":"https://ror.org/025vmq686","country_code":"BR","type":"education","lineage":["https://openalex.org/I45643870"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Nat\u00e1lia Junkes Milioli","raw_affiliation_strings":["School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Brazil"],"raw_orcid":"https://orcid.org/0000-0001-5424-2118","affiliations":[{"raw_affiliation_string":"School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Brazil","institution_ids":["https://openalex.org/I45643870"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5017959764","display_name":"Tulio L Correa","orcid":"https://orcid.org/0000-0003-4524-6736","observed_orcids":["https://orcid.org/0000-0003-4524-6736"]},"institutions":[{"id":"https://openalex.org/I170201317","display_name":"University of Pittsburgh","ror":"https://ror.org/01an3r305","country_code":"US","type":"education","lineage":["https://openalex.org/I170201317"]},{"id":"https://openalex.org/I4210134769","display_name":"University of Pittsburgh Medical Center","ror":"https://ror.org/04ehecz88","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210098814","https://openalex.org/I4210134769"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Tulio L Correa","raw_affiliation_strings":["School of Medicine, University of Pittsburgh Medical Center, United States"],"raw_orcid":"https://orcid.org/0000-0003-4524-6736","affiliations":[{"raw_affiliation_string":"School of Medicine, University of Pittsburgh Medical Center, United States","institution_ids":["https://openalex.org/I170201317","https://openalex.org/I4210134769"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5089567214","display_name":"Ot\u00e1vio Cosendey Martins","orcid":"https://orcid.org/0000-0003-2237-2799","observed_orcids":["https://orcid.org/0000-0003-2237-2799"]},"institutions":[{"id":"https://openalex.org/I101100930","display_name":"Universidade Federal de Juiz de Fora","ror":"https://ror.org/04yqw9c44","country_code":"BR","type":"education","lineage":["https://openalex.org/I101100930"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Otavio Cosendey Martins","raw_affiliation_strings":["School of Medicine, Federal University of Juiz de Fora, Brazil"],"raw_orcid":"https://orcid.org/0000-0003-2237-2799","affiliations":[{"raw_affiliation_string":"School of Medicine, Federal University of Juiz de Fora, Brazil","institution_ids":["https://openalex.org/I101100930"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5063669776","display_name":"Pedro Henrique Carvalho Leite Romeiro","orcid":"https://orcid.org/0000-0003-2286-4582","observed_orcids":["https://orcid.org/0000-0003-2286-4582"]},"institutions":[{"id":"https://openalex.org/I181391015","display_name":"Universidade Estadual de Campinas (UNICAMP)","ror":"https://ror.org/04wffgt70","country_code":"BR","type":"education","lineage":["https://openalex.org/I181391015"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Pedro Romeiro","raw_affiliation_strings":["School of Medicine, State University of Campinas, Brazil"],"raw_orcid":"https://orcid.org/0000-0003-2286-4582","affiliations":[{"raw_affiliation_string":"School of Medicine, State University of Campinas, Brazil","institution_ids":["https://openalex.org/I181391015"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5093994214","display_name":"El\u00edsio Bulh\u00f5es","orcid":"https://orcid.org/0000-0003-1156-4015","observed_orcids":["https://orcid.org/0000-0003-1156-4015"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"El\u00edsio Santos Bulh\u00f5es J\u00fanior","raw_affiliation_strings":["College of Higher Education of the United Amazon, Brazil"],"raw_orcid":"https://orcid.org/0000-0003-1156-4015","affiliations":[{"raw_affiliation_string":"College of Higher Education of the United Amazon, Brazil","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5103504659","display_name":"Andr\u00e9 Milani Reis","orcid":"https://orcid.org/0009-0003-5242-3419","observed_orcids":["https://orcid.org/0009-0003-5242-3419"]},"institutions":[{"id":"https://openalex.org/I181391015","display_name":"Universidade Estadual de Campinas (UNICAMP)","ror":"https://ror.org/04wffgt70","country_code":"BR","type":"education","lineage":["https://openalex.org/I181391015"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Andr\u00e9 Milani Reis","raw_affiliation_strings":["School of Medicine, State University of Campinas, Brazil"],"raw_orcid":"https://orcid.org/0009-0003-5242-3419","affiliations":[{"raw_affiliation_string":"School of Medicine, State University of Campinas, Brazil","institution_ids":["https://openalex.org/I181391015"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5077456267","display_name":"Matheus Vanzin Fernandes","orcid":"https://orcid.org/0000-0002-1179-0912","observed_orcids":["https://orcid.org/0000-0002-1179-0912"]},"institutions":[{"id":"https://openalex.org/I134363262","display_name":"Universidade Federal de Ci\u00eancias da Sa\u00fade de Porto Alegre","ror":"https://ror.org/00x0nkm13","country_code":"BR","type":"education","lineage":["https://openalex.org/I134363262"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Matheus Vanzin Fernandes","raw_affiliation_strings":["School of Medicine, Porto Alegre Health Sciences Federal University, Porto Alegre, Brazil"],"raw_orcid":"https://orcid.org/0000-0002-1179-0912","affiliations":[{"raw_affiliation_string":"School of Medicine, Porto Alegre Health Sciences Federal University, Porto Alegre, Brazil","institution_ids":["https://openalex.org/I134363262"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":7,"corresponding_author_ids":["https://openalex.org/A5104209044"],"corresponding_institution_ids":["https://openalex.org/I51235708"],"apc_list":null,"apc_paid":null,"fwci":1.3613,"has_fulltext":true,"cited_by_count":2,"citation_normalized_percentile":{"value":0.74674385,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":95,"max":96},"biblio":{"volume":"7","issue":"1","first_page":"4","last_page":"13"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10337","display_name":"Liver Disease and Transplantation","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2721","display_name":"Hepatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10337","display_name":"Liver Disease and Transplantation","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2721","display_name":"Hepatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10858","display_name":"Clinical Nutrition and Gastroenterology","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2916","display_name":"Nutrition and Dietetics"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11207","display_name":"Alcohol Consumption and Health Effects","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2734","display_name":"Pathology and Forensic Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/hepatic-encephalopathy","display_name":"hepatic encephalopathy","score":0.9980000257492065},{"id":"https://openalex.org/keywords/intravenous-albumin","display_name":"intravenous albumin","score":0.9739999771118164},{"id":"https://openalex.org/keywords/decompensated-cirrhosis","display_name":"decompensated cirrhosis","score":0.9549999833106995},{"id":"https://openalex.org/keywords/mortality","display_name":"mortality","score":0.9620000123977661},{"id":"https://openalex.org/keywords/ammonia-concentration","display_name":"ammonia concentration","score":0.7609999775886536},{"id":"https://openalex.org/keywords/liver-transplantation","display_name":"liver transplantation","score":0.9549999833106995},{"id":"https://openalex.org/keywords/adverse-events","display_name":"adverse events","score":0.9559999704360962},{"id":"https://openalex.org/keywords/oxidative-stress","display_name":"oxidative stress","score":0.7269999980926514},{"id":"https://openalex.org/keywords/trial-sequential-analysis","display_name":"trial sequential analysis","score":0.8700000047683716}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8019999861717224},{"id":"https://openalex.org/C2776125364","wikidata":"https://www.wikidata.org/wiki/Q169219","display_name":"Albumin","level":2,"score":0.7168999910354614},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.5364000201225281},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.4984999895095825},{"id":"https://openalex.org/C165616093","wikidata":"https://www.wikidata.org/wiki/Q424232","display_name":"Serum albumin","level":2,"score":0.4876999855041504},{"id":"https://openalex.org/C3019038604","wikidata":"https://www.wikidata.org/wiki/Q11721976","display_name":"Human albumin","level":3,"score":0.4406999945640564},{"id":"https://openalex.org/C90924648","wikidata":"https://www.wikidata.org/wiki/Q120569","display_name":"Gastroenterology","level":1,"score":0.391400009393692},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.35760000348091125},{"id":"https://openalex.org/C95190672","wikidata":"https://www.wikidata.org/wiki/Q815382","display_name":"Meta-analysis","level":2,"score":0.35409998893737793},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.3089999854564667},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.25940001010894775}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.14744/hf.2025.58807","doi":"https://doi.org/10.14744/hf.2025.58807","is_oa":true,"landing_page_url":"https://doi.org/10.14744/hf.2025.58807","pdf_url":"https://hepatologyforum.org/storage/upload/pdfs/1768477734-en.pdf","source":{"id":"https://openalex.org/S4210219018","display_name":"Hepatology forum/Hepatology forum (Online)","issn_l":"2757-7392","issn":["2757-7392","1307-5888"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","poland-20","russia-white-list-4","tr-dizin"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Hepatology Forum","raw_type":"journal-article"},{"id":"pmid:41589201","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/41589201","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Hepatology forum","raw_type":"Journal Article"},{"id":"pmh:oai:pubmedcentral.nih.gov:12831988","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12831988/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Hepatol Forum","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.14744/hf.2025.58807","doi":"https://doi.org/10.14744/hf.2025.58807","is_oa":true,"landing_page_url":"https://doi.org/10.14744/hf.2025.58807","pdf_url":"https://hepatologyforum.org/storage/upload/pdfs/1768477734-en.pdf","source":{"id":"https://openalex.org/S4210219018","display_name":"Hepatology forum/Hepatology forum (Online)","issn_l":"2757-7392","issn":["2757-7392","1307-5888"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","poland-20","russia-white-list-4","tr-dizin"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Hepatology Forum","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/systematic-review","display_name":"Systematic Review"},{"id":"https://openalex.org/study-designs/meta-analysis","display_name":"Meta-Analysis"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7124299002.pdf","grobid_xml":"https://content.openalex.org/works/W7124299002.grobid-xml"},"referenced_works_count":31,"referenced_works":["https://openalex.org/W1534181333","https://openalex.org/W1965874394","https://openalex.org/W1971689007","https://openalex.org/W1975572916","https://openalex.org/W1982049192","https://openalex.org/W2003206548","https://openalex.org/W2006957711","https://openalex.org/W2014782195","https://openalex.org/W2088910001","https://openalex.org/W2105932465","https://openalex.org/W2146276801","https://openalex.org/W2166669752","https://openalex.org/W2170892587","https://openalex.org/W2551362867","https://openalex.org/W2553083290","https://openalex.org/W2592541035","https://openalex.org/W2806141881","https://openalex.org/W2891130223","https://openalex.org/W2911852906","https://openalex.org/W2970684805","https://openalex.org/W2979371797","https://openalex.org/W3036368019","https://openalex.org/W3118615836","https://openalex.org/W3184236829","https://openalex.org/W3204905245","https://openalex.org/W3208659365","https://openalex.org/W4281800548","https://openalex.org/W4294126893","https://openalex.org/W4296984360","https://openalex.org/W4368340905","https://openalex.org/W4376107736"],"related_works":["https://openalex.org/W4399345136","https://openalex.org/W3204905245","https://openalex.org/W3162901038","https://openalex.org/W4387749887","https://openalex.org/W3208659365","https://openalex.org/W2979371797","https://openalex.org/W1965874394","https://openalex.org/W4404975591","https://openalex.org/W4296984360","https://openalex.org/W4281555641"],"abstract_inverted_index":{"Background":[0],"and":[1,11,45,55,62,68,86,93,107,130,171,199,241],"Aim:":[2],"Hepatic":[3],"encephalopathy":[4],"(HE)":[5],"is":[6,212,227],"a":[7,59,154],"complication":[8],"of":[9,13,18,36,47,52,96,266],"cirrhosis":[10],"one":[12],"the":[14,25,34,43,50,65,108,126,209,225,251,264],"most":[15],"important":[16],"manifestations":[17],"this":[19,272],"disease.":[20],"Intravenous":[21],"albumin":[22,48,79,158,219,236,267],"may":[23],"have":[24],"potential":[26],"to":[27,33,41,80,149,167,180,185,238,259,268],"mitigate":[28],"oxidative":[29],"stress":[30],"injury":[31],"inherent":[32],"pathogenesis":[35],"HE.":[37,53,97],"Our":[38],"study":[39,144],"aims":[40],"evaluate":[42],"efficacy":[44],"safety":[46],"for":[49,73,104,112,139,160,172,215],"treatment":[51],"Materials":[54],"Methods:":[56],"We":[57,71],"performed":[58,138],"systematic":[60],"review":[61],"meta-analysis":[63],"using":[64,125],"PubMed,":[66],"Embase,":[67],"Cochrane":[69],"databases.":[70],"searched":[72],"randomized":[74],"controlled":[75],"trials":[76],"(RCTs)":[77],"comparing":[78],"placebo":[81],"in":[82,192,247,271],"patients":[83,232],"with":[84,115,218,233],"HE":[85,173,239],"decompensated":[87],"cirrhosis.":[88],"The":[89,98],"outcomes":[90,106,114],"were":[91],"mortality":[92,161,216,270],"clinical":[94],"improvement":[95,174,240],"odds":[99],"ratio":[100],"(OR)":[101],"was":[102,123,137,153,188],"used":[103],"binary":[105],"mean":[109],"difference":[110,156,191],"(MD)":[111],"continuous":[113],"their":[116],"respective":[117],"95%":[118,164,177],"confidence":[119],"interval":[120],"(CI).":[121],"Heterogeneity":[122],"assessed":[124],"Cochran":[127],"Q":[128],"test":[129],"I\u00b2":[131],"statistics.":[132],"Trial":[133],"sequential":[134],"analysis":[135],"(TSA)":[136],"all":[140],"outcomes.":[141],"Results:":[142],"This":[143],"included":[145],"four":[146],"RCTs,":[147],"amounting":[148],"306":[150],"patients.":[151],"There":[152,187],"significant":[155,190,200,214],"favoring":[157],"use":[159,265],"(OR":[162,175],"0.44;":[163],"CI":[165,178],"0.24":[166],"0.79;":[168],"p=0.007;":[169],"I2=0%)":[170],"2.41;":[176],"1.22":[179],"4.75,":[181],"p=0.011;":[182],"I2=34.9%)":[183],"compared":[184],"placebo.":[186],"no":[189],"ammonia":[193],"levels":[194],"(p=0.580),":[195],"liver":[196],"transplantation":[197],"(p=0.732),":[198],"adverse":[201],"events":[202],"(AE)":[203],"rate":[204],"(p=0.586).":[205],"TSA":[206,252],"revealed":[207],"that":[208,254],"pooled":[210],"effect":[211],"statistically":[213],"reduction":[217],"use;":[220],"however,":[221],"regarding":[222,263],"sample":[223],"size,":[224],"result":[226],"not":[228],"definitive.":[229],"Conclusion:":[230],"In":[231],"HE,":[234],"intravenous":[235],"leads":[237],"reduced":[242],"mortality,":[243],"without":[244],"an":[245],"increase":[246],"AE":[248],"rates.":[249],"However,":[250],"indicated":[253],"further":[255],"studies":[256],"are":[257],"required":[258],"draw":[260],"precise":[261],"evidence":[262],"reduce":[269],"population.":[273]},"counts_by_year":[{"year":2026,"cited_by_count":2}],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2026-01-16T00:00:00"}