Pacientes com encefalopatia hepática no serviço de Emergência: Uma revisão de literatura sobre os benefícios da Erradicação do helicobacter pylori

Abstract

Hepatic encephalopathy (HE) is a set of potentially reversible signs and symptoms observed in the face of impaired brain function in patients with an advanced hepatic pathological process. The ways in which brain dysfunction occurs in liver failure are still poorly understood. Most therapeutic measures focus on controlling the accumulation of neurotoxins, such as serum ammonia. Helicobacter pylori infection is associated with ammonia production, so the eradication of H. pylori could have benefits, however, so far such an advantage is seen only in theory. Based on the potential severity, HE is a frequent diagnosis in the emergency department (ED), making knowledge of identification and management important. Despite this, little progress has been made as clinical trials are difficult in the face of this enigmatic reality. The objective of this work was to summarize the benefits of H. pylori eradication in patients diagnosed with HE in the ED. This research is a descriptive study with secondary data collection through a bibliographic survey of the integrative literature review type. The search initially found a total of 371 studies through an active search in databases (LiLacs, SciELO, PubMed, EMBASE, Cochrane Library and Web of Science), after applying the exclusion criteria, following that proposed by PRISMA 2020, 19 articles were selected for full reading. It was possible to analyze the benefits in some studies of eradicating H. pylori in patients with HE, when associated with a higher risk of mortality, presence of recurrent infections, higher concentration of complications and decompensation culminating in neuropsychological disorders. AntiH. pylori could alleviate the poor prognosis and provide a better quality of life, by reducing the incidence of precipitating events, recurrences, length of stay and number of hospitalizations. It is expected that further studies with larger prospective trials to evaluate the use of tools in therapeutic management can clearly demonstrate the effectiveness in the prognosis and survival of patients with HE and, therefore, enable better management of them in the ED.