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Current Hepatology Reports

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01-03-2020 | Hepatic Encephalopathy | Nutrition in Patients with Chronic Liver Disease (E Tapper, Section Editor)

Nutrition Management in the Critically Ill Patient with Cirrhosis

Authors: Amy R. Kennett, Jody C. Olson

Published in: Current Hepatology Reports | Issue 1/2020

Abstract

Purpose of Review

Nutrition assessment of patients with liver failure in the intensive care unit is complex due to the decompensated state of the patient. Malnutrition is highly prevalent and recommendations for protein intake and other supportive measures have changed over the past several years. This review will describe the nutritional assessment of patients with cirrhosis in the intensive care unit and provide recommendations for updated best practices of nutritional support.

Recent Findings

More recent research has focused on the benefit of early nutrition interventions, avoiding prolonged fasting, and higher protein provision. Other supportive nutrition interventions such as the use of branch chain amino acids, probiotic therapy, and zinc supplementation have shown mixed results and have not been recently studied in the setting of critical illness.

Summary

Patients with advanced cirrhotic stage liver disease are often concurrently malnourished. When cirrhotic patients become critically ill, nutritional deficits can rapidly worsen leading to progressive functional decline. By utilization of best practices, the risk of progressive nutritional decline may be mitigated.

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Title: Nutrition Management in the Critically Ill Patient with Cirrhosis
Authors: Amy R. Kennett
Jody C. Olson
Publication date: 01-03-2020
Publisher: Springer US
Keywords: Hepatic Encephalopathy
Acute Liver Failure
Nutrition
Malnutrition
Hepatic Encephalopathy
Published in: Current Hepatology Reports / Issue 1/2020
Electronic ISSN: 2195-9595
DOI: https://doi.org/10.1007/s11901-020-00506-0

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