Nutrition in Critical Care Hepatology

AbstractPurpose of ReviewPatients with cirrhosis necessitating admission to the intensive care unit are often malnourished and have a high short-term mortality. This review describes the role of nutritional therapy in improving outcomes in critically ill patients with liver disease. We also describe nutritional needs in special situations like hepatic encephalopathy, gastrointestinal bleed, acute liver failure, alcohol-associated hepatitis, and acute-on-chronic liver failure.Recent FindingsMalnutrition and sarcopenia are identified as predictors of high wait-list mortality and poor post-transplant outcomes in cirrhosis. Recent studies highlight the role of intensive enteral nutrition in critically ill patients with cirrhosis. Early initiation of enteral nutrition after an episode of gastrointestinal bleed is now recommended. Protein restriction in patients with hyperammonemia like acute liver failure or hepatic encephalopathy is now obsolete. Immunonutrition by ω-3 fatty acid lipid emulsions helps in reducing hospital stay in patients with gastrointestinal bleed and prevents sepsis in patients with acute-on-chronic liver failure. The use of micronutrients like thiamine, zinc, phosphorus, etc. in hepatology intensive care and the role of frequent small mea ls to prevent muscle catabolism is under research. Improvement in enteral nutrition formulas and reduced dependence on parenteral nutrition is required.SummaryAlthough malnutrition is associated with poor outcomes in cirrho...
Source: Current Hepatitis Reports - Category: Infectious Diseases Source Type: research