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Acute Hepatic Failure and Nutrition.

Publication ,  Journal Article
Kappus, MR
Published in: Nutr Clin Pract
February 2020

Malnutrition is prevalent in patients with hepatic failure and remains an independent risk factor for morbidity and mortality in these patients. Factors that contribute to malnutrition in this patient population include altered metabolic rate, fat malabsorption, and impaired gastric emptying, all in the setting of an acute and potentially prolonged hospitalization. Acute liver failure (ALF), different from cirrhosis or chronic liver disease, is an uncommon but dramatic clinical syndrome that demonstrates severe and rapid decline in hepatic metabolic function. ALF has a significant risk of mortality. There are >10 cases per million persons per year in developed countries, but ALF presents with unique challenges in clinical management related to heterogeneity in severity and etiology. Patients with ALF by definition should not have a prior history of liver disease, and liver disease is subsequently defined by the onset of liver injury, the presence of hepatic encephalopathy (HE), and coagulopathy as defined by an international normalized ratio > 1.5. HE usually develops within 1-4 weeks of the onset of liver injury but may occur within 26 weeks of the initial presentation. Rates of survival from ALF have improved over recent years, but the rarity and severity of presentation have resulted in traditionally limited evidence to guide basic supportive care. Over time, advances in critical care management and the use of emergency liver transplantation have improved. In this article, we will review current nutrition considerations for patients with ALF.

Duke Scholars

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Published In

Nutr Clin Pract

DOI

EISSN

1941-2452

Publication Date

February 2020

Volume

35

Issue

1

Start / End Page

30 / 35

Location

United States

Related Subject Headings

  • Risk Factors
  • Parenteral Nutrition
  • Nutritional Status
  • Nutrition Therapy
  • Nutrition Assessment
  • Nutrition & Dietetics
  • Malnutrition
  • Liver Transplantation
  • Liver Failure, Acute
  • Liver Diseases
 

Citation

APA
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ICMJE
MLA
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Kappus, M. R. (2020). Acute Hepatic Failure and Nutrition. Nutr Clin Pract, 35(1), 30–35. https://doi.org/10.1002/ncp.10462
Kappus, Matthew Robert. “Acute Hepatic Failure and Nutrition.Nutr Clin Pract 35, no. 1 (February 2020): 30–35. https://doi.org/10.1002/ncp.10462.
Kappus MR. Acute Hepatic Failure and Nutrition. Nutr Clin Pract. 2020 Feb;35(1):30–5.
Kappus, Matthew Robert. “Acute Hepatic Failure and Nutrition.Nutr Clin Pract, vol. 35, no. 1, Feb. 2020, pp. 30–35. Pubmed, doi:10.1002/ncp.10462.
Kappus MR. Acute Hepatic Failure and Nutrition. Nutr Clin Pract. 2020 Feb;35(1):30–35.
Journal cover image

Published In

Nutr Clin Pract

DOI

EISSN

1941-2452

Publication Date

February 2020

Volume

35

Issue

1

Start / End Page

30 / 35

Location

United States

Related Subject Headings

  • Risk Factors
  • Parenteral Nutrition
  • Nutritional Status
  • Nutrition Therapy
  • Nutrition Assessment
  • Nutrition & Dietetics
  • Malnutrition
  • Liver Transplantation
  • Liver Failure, Acute
  • Liver Diseases