Effects of the Administration of Ornithine Phenylacetate in Patients With Cirrhosis and Upper Gastrointestinal Bleeding

Exclusion Criteria

• •Terminal illness (e.g. advanced hepatocellular carcinoma).
• •Need for mechanical ventilation.
• •Renal impairment, defined by a creatinine \> 1.5 mg/dl or need of hemodialysis.
• •Pregnant or breast-feeding. Pre-menopausal women capable of bearing children should be following a reliable method of birth control and should have a negative result in a pregnancy test prior to inclusion.
• •Known or suspected hypersensitivity or allergic reaction to ornithine or phenylacetate.
• •Use of medications known to interfere with the clearance of either ornithine and/or phenylacetate, such as antibiotics of the penicillin group and probenicid.
• •Use of medications that may induce hyperammonemia; such as haloperidol, valproic acid, and systemic corticosteroids.
• •History or known infection with human immunodeficiency virus (HIV).
• •Neurological comorbidities that impair mental status and do not allow to adequately assess the presence or outcome of hepatic encephalopathy.
• •The presence in the electrocardiogram of a QTcF \>500 msec