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Nutritional management for acute liver failure.

Tokio Sasaki1, Keisuke Kakisaka1, Hidekatsu Kuroda1

  • 1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University, School of Medicine, Yahaba, Japan.

Hepatology Research : the Official Journal of the Japan Society of Hepatology
|July 1, 2024
PubMed
Summary

Nutritional management is key for acute liver failure (ALF) patients, addressing hypermetabolism and nutrient disruptions. Tailored nutrition, considering energy, glucose, and protein needs, improves outcomes in ALF and hepatic encephalopathy.

Keywords:
acute liver failureammoniaenteral nutritionhepatic encephalopathy

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Area of Science:

  • Hepatology
  • Clinical Nutrition
  • Metabolic Disorders

Background:

  • Acute liver failure (ALF) causes hypermetabolism and disrupts nutrient metabolism.
  • Hepatic encephalopathy, a complication of ALF, is linked to amino acid metabolic disturbances.

Purpose of the Study:

  • To review nutritional management strategies for ALF based on its pathophysiology.
  • To emphasize individualized nutritional support considering hepatocyte function impairment.

Main Methods:

  • Review of existing literature on nutritional support in ALF.
  • Analysis of metabolic disturbances in ALF, including energy, glucose, and protein metabolism.

Main Results:

  • Enteral nutrition is preferred; parenteral nutrition is an alternative.
  • Energy intake should be ~1.3 times resting energy expenditure.
  • Substantial glucose and appropriate protein intake, with ammonia monitoring, are recommended.

Conclusions:

  • Nutritional management is pivotal in ALF therapy.
  • Individualized nutritional plans are essential for acute, recovery, and pretransplant phases.
  • Understanding nutritional pathophysiology guides effective treatment for ALF patients.