Ammonia measurement in cirrhosis: International Delphi consensus recommendations from ISHEN

The authors aimed to establish evidence-based recommendations for the measurement of ammonia in patients with cirrhosis, addressing its clinical significance and utility in diagnosing, monitoring, and treating hepatic encephalopathy (HE). Through a modified Delphi process involving a diverse panel of experts, the consensus reached over 90% agreement on best practices for ammonia measurement and its role in patient care. This document serves as a foundational guideline for clinicians and highlights critical areas for future research to improve patient outcomes related to ammonia and HE.