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In sepsis, Kupffer cells, the resident macrophages in the liver sinusoids, become activated and continue to synthesize pro-inflammatory factors (such as TNF-, IL-6, IL-18 and IL-1), secrete chemokines and leukotrienes, and initiate ROS and NO production

Prem Kandiah, neurointensivist, transplant intensivist, and ammonia enthusiast, we explore the physiology of hyperammonemia, the nuances of its measurement and interpretation, and unpack some less-recognized causes, including infection by urease-producing organisms and malnutrition/gastric bypass

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