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Hyperalimentation in alcoholic hepatitis.

J T Galambos, T Hersh, J T Fulenwider

    The American Journal of Gastroenterology
    |November 1, 1979
    PubMed
    Summary
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    Parenteral nutrition (P-900) improved clinical outcomes in patients with severe alcoholic hepatitis and anorexia. This intravenous nutrition effectively supplemented oral intake without causing encephalopathy.

    Area of Science:

    • Hepatology
    • Gastroenterology
    • Clinical Nutrition

    Background:

    • Severe alcoholic hepatitis often presents with anorexia and malnutrition, impairing clinical recovery.
    • Oral intake is frequently insufficient to meet nutritional demands in critically ill patients with alcoholic hepatitis.

    Purpose of the Study:

    • To evaluate the efficacy and safety of peripheral parenteral nutrition (P-900) in patients with severe alcoholic hepatitis.
    • To assess the impact of intravenous nutrition on clinical improvement, nitrogen balance, and complications like encephalopathy.

    Main Methods:

    • Administered a 900 mosM/l. parenteral nutrition solution (P-900) via peripheral vein to patients with alcoholic hepatitis.
    • Supplemented oral intake with daily amino acid infusions (51.6-77.4 gm).

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  • Monitored clinical status, nitrogen balance, and incidence of encephalopathy, hyponatremia, and renal failure.

    • Main Results:

    • P-900 therapy led to clinical improvement and increased nitrogen balance in patients with anorexia and severe alcoholic hepatitis.
    • All patients receiving P-900 showed improvement, with no detectable encephalopathy during 16-42 days of therapy.
    • Four out of five patients with ascites and alcoholic hepatitis tolerated P-900 without hyponatremia, renal failure, or encephalopathy, and continued diuresis.

    Conclusions:

    • Parenteral nutrition (P-900) is an effective adjunctive therapy for clinically ill patients with alcoholic hepatitis, even when oral intake is limited.
    • Intravenous nutrition can be safely administered to supplement oral intake in alcoholic hepatitis patients, without precipitating encephalopathy or interfering with ascites management.
    • P-900 therapy offers a viable nutritional support option for patients with severe alcoholic hepatitis, improving outcomes and nitrogen balance.