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[Parenteral nutrition in liver insufficiency]
Schweizerische Medizinische Wochenschrift
|April 26, 1986
Summary
Parenteral nutrition for liver insufficiency should be in an all-in-one solution. Branched-chain amino acids (BCAA) treat hepatic encephalopathy, but exogenous amino acid supply is contraindicated in severe metabolic disturbances.
Area of Science:
- Clinical Nutrition
- Hepatology
- Metabolic Disorders
Context:
- Parenteral nutrition regimens for liver insufficiency are evolving.
- All-in-one solutions are preferred for energy and nitrogen supply.
- Hepatic encephalopathy (HE) management often involves specific amino acid therapies.
Purpose:
- To review current recommendations for parenteral nutrition in liver insufficiency.
- To discuss the role of branched-chain amino acids (BCAA) in treating hepatic encephalopathy.
- To identify contraindications for exogenous amino acid administration.
Summary:
- Liver insufficiency parenteral nutrition should utilize all-in-one solutions with glucose, fat, and liver-adapted amino acids.
- Branched-chain amino acids (BCAA) are recommended for hepatic encephalopathy (HE), with dosage adjusted to clinical status.
- Exogenous amino acid supply is contraindicated in severe gluconeogenesis impairment (hypoglycemia with hyperlactatemia) or ammonia elimination failure (low urea nitrogen production with hyperammonemia).
Impact:
- Facilitates metabolic monitoring and reduces infection risk in liver insufficiency patients.
- Allows for individualized BCAA dosing for optimal hepatic encephalopathy (HE) treatment.
- Prevents adverse effects by avoiding amino acid administration when contraindicated in critical metabolic states.