West Haven Criteria (Hepatic Encephalopathy Grade)
Grades severity of hepatic encephalopathy (HE) using the West Haven Criteria (Conn criteria). Guides treatment intensity and monitoring.
Score interpretation
Minimal HE or West Haven grade 1 (covert HE).
→ Lactulose; identify/treat precipitants; dietary advice; outpatient review
West Haven grade 2: lethargy, disorientation for time, asterixis.
→ Admit; lactulose; rifaximin; treat precipitants; nutrition support; close monitoring
West Haven grade 3 (somnolent, gross disorientation) or 4 (coma).
→ ICU consideration; airway protection; IV lactulose or enema; transplant assessment; treat precipitants aggressively
Interpretation bands for the West Haven / HE Grade. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Lactulose · Osmotic laxative / Ammonia reduction (hepatic encephalopathy)
- Lactulose (Hepatic Encephalopathy) · Osmotic Laxative / Ammonia-Reducing Agent
- Lactulose (Paediatric) · Osmotic Laxative — Constipation / Hepatic Encephalopathy
- Rifaximin · Non-Absorbable Antibiotic (Hepatic Encephalopathy / IBS-D)
- Dobutamine (Acute HF / Stress Echo) · Inotrope / Acute Heart Failure
- Milrinone · Inodilator / Acute Heart Failure
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.