Comparison of the Effectiveness and Safety Profile of Polyethylene Glycol-Electrolyte Solution with Lactulose in patients of Overt Hepatic Encephalopathy

Aim: To compare the effectiveness and safety profile of polyethylene glycol-electrolyte solution with lactulose in patients of overt hepatic encephalopathy. Study design: Randomized controlled trial Place and duration of study: South Medical Ward, Mayo Hospital, Lahore from 10th January, 2017 to 9th June, 2017. Methodology: A sample size of 94 patients was taken using non-probability purposive sampling technique. Group A consisting of 47 patients were given polyethylene glycol-electrolyte solution (500 ml) and Group B comprising 47 patients were given lactulose (30 ml). Serum sodium and potassium levels were checked at 0, 12 and 24 hours. The data was analyzed using computer software SPSS version 17.0. Results: The mean age of all cases was 39.98 +/- 13.63 years. Overall there were 56(59.6%) male and 38(40.4%) female cases. Serum sodium and potassium levels remained normal at 0 and 12 hours while at 24 hours, there were 3(6.4%) cases in group-A and 4(8.5%) cases in group-B who developed hyponatremia, p-value > 0.05. Moreover only 2(4.3%) cases in group-A and 3(6.4%) in group-B at 24 hours had low serum potassium levels, p-value > 0.05. The mean hospital stay in group-A was 3.30 +/- 1.59 days and in group-B was 4.11 +/- 2.12 days, the mean hospital stay in group-A was significantly lower than group-B, p-value = 0.039. The mean improvement in Modified Orientation Log score in group-A was 11 +/- 3.61 and in group-B was 6.81 +/- 2.13 with significantly higher improvement in group-A than in group-B, p-value < 0.0001. Conclusion: It was concluded that Polyethylene glycol-electrolyte solution is better in effectiveness and safety in patients of overt hepatic encephalopathy when compared with lactulose.