BENZODIAZEPINE-LIKE COMPOUNDS IN THE PLASMA OF PATIENTS WITH FULMINANT HEPATIC-FAILURE

Background: Benzodiazepine-like compounds have been implicated in the pathogenesis of encephalopathy after fulminant hepatic failure. Method s: The levels and the nature of benzodiazepine-like compounds were det ermined in six cases of fulminant hepatic failure during the course of the disease. Blood samples were collected on admission and a few days later, when the neurologic status had improved in five cases and imme diately before death in one case. The compounds were measured in sera with a binding technique after high-performance liquid chromatography purification and analyzed with mass spectrometry;, Results: Their leve ls were highly variable in those with severe encephalopathy and were s till Increased on awakening in some cases. Diazepam and N-desmethyldia zepam were inconsistently present. Conclusions: The inconsistent prese nce of benzodiazepine-like compounds in encephalopathy after fulminant hepatic failure and their persistence, in some cases, at high levels on awakening from coma seem to Indicate that the encephalopathy is not strictly dependent on the levels of these compounds.