Hepatic Encephalopathy: Achieving Care Goals in the Acute Setting and Beyond




HE is a brain dysfunction caused by liver insufficiency and/or portosystemic shunting (PSS). It manifests as subneurological or psychiatric abnormalities that range in severity from subclinical alterations, which are only detectable with neuropsychiatric testing, to coma. Underlying these abnormalities is the buildup of ammonia in the blood, which causes brain swelling and ultimately leads to impairments in function. In the absence of effective treatment, HE is associated with poor survival and carries with it a high risk of recurrence and hospitalization.



Robert Rahimi, MD
Transplant Hepatology
Baylor University Medical Center
Assistant Professor
Department of Medicine
Texas A&M Health Science Center
College of Medicine
Liver Consultants of Texas
Baylor Charles A. Sammons Cancer Center
Dallas, Texas


Release date: October 10, 2019
Expiration date: October 10, 2020
Estimated time to complete activity: 1.0 hour(s)



This educational initiative has been designed for hospitalists and internal medicine physicians and hospital-based clinicians involved with the diagnosis and management of patients with HE.


Upon completion of this educational activity, participants should be able to:

  • Identify symptoms and risk factors of HE and approaches to diagnosis that are concordant with current guidelines recommendations
  • Utilize available clinical and observational data to design effective acute and prophylactic treatment regimens for patients with HE
  • Implement transitional and long-term care strategies to reduce rehospitalization in patients with HE

There are no fees for participating and receiving CME credit for this activity. During the period of October 10, 2019 through October 10, 2020, participants must:

  • Read the learning objectives and faculty disclosures
  • Complete the pretest
  • Study the educational activity
  • Complete the posttest and the evaluation form

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better. Pharmacists must check the CPE monitor for their credits within 60 days of the activity.




Integrity Continuing Education is accredited with commendation by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.


Integrity Continuing Education designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Pharmacy Education
Global Education Group is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Global Education Group designates this continuing education activity for a total of 1.0 contact hour(s) (.10 CEUs) of the Accreditation Council for Pharmacy Education.

Universal Activity Number – 0530-9999-19-111-H01-P
This is a knowledge-based activity.

Continuing Nursing Education
Global Education Group is accredited with distinction as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This educational activity for 1.0 contact hours is provided by Global Education Group.
Nurses should claim only the credit commensurate with the extent of their participation in the activity.


For information about ACCME accreditation of this activity, please contact Integrity Continuing Education at (855) 835-4004 or hmf@integrityce.com.

For information about ACPE or ANCC accreditation of this activity, please contact Global Education Group at 303-395-1782 or cme@globaleducationgroup.com.


Integrity Continuing Education and Global Education Group require instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Integrity Continuing Education and Global Education Group for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations. Integrity Continuing Education and Global Education Group are committed to providing learners with high-quality CME/CE activities and related materials that promote improvement or quality in healthcare and not a specific proprietary business interest or a commercial interest.

The following faculty/planners reported their financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Robert Rahimi, MD
Consultant: Mallinckrodt
Research: Mallinckrodt, Valeant Pharmaceuticals North America LLC

The following planner and manager, Rachel Brown, PharmD, Ashley Marostica, RN, MSN, Lindsay Borvansky, Andrea Funk, Ashley Cann, Liddy Knight, hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months. The Global planners and managers have nothing to disclose.


This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Postgraduate Institute for Medicine and Integrity Continuing Education do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


When you participate in an online educational activity sponsored by Integrity Continuing Education, Inc., you will be asked for your name, degree(s), affiliation(s), street address, telephone number, fax number, and…(continued)


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The information provided at this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.


This CME activity is provided by Integrity Continuing Education.

This CE activity is jointly provided by Global Education Group and Integrity Continuing Education.


Supported by an educational grant from Salix Pharmaceuticals, Inc.

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