Ammonia measurement in cirrhosis: International Delphi consensus recommendations from ISHEN

This is the first international, evidence-based consensus describing the role of ammonia measurement in patients with cirrhosis. The consensus details guidance on how to measure ammonia, the role of ammonia measurement to predict development of overt hepatic encephalopathy and other liver-related complications, and its role in the diagnosis and prognosis of patients with overt hepatic encephalopathy. This document will help harmonise practices across the world in the way ammonia should be measured and reported, impacting significantly on patient outcomes, research and drug development efforts.