Nutritional Management of Liver Cirrhosis and Its Complications in Hospitalized Patients

Abstract

BACKGROUND: Cirrhosis is a chronic and progressive liver disease that occurs from prolonged hepatocellular injury. Malnutrition causes complications in cirrhosis patients that worsen the condition to liver failure. Both are closely linked and increase the chances of morbidity and mortality. Regular nutritional screening and monitoring is prime concern for such patients including comprehensive dietary history, laboratory tests, and evaluation of muscle loss and strength capabilities to determine the degree of frailty. For efficient assessment of liver cirrhosis patients Subjective Global Assessment has been used worldwide. The nutritional objectives for such individuals should be to regain liver functions, to prevent complications associated, and to overcome nutritional deficiencies causing malnutrition. METHODS: We conducted a literature review using PubMed, Google Scholar and Science Direct for this purpose, a total of 130 articles were reviewed out of which 80 (from the past 5 years) including originally published research, review articles and abstracts were also included. Exclusion criteria of the selected studies was year of publication, irrelevancy and animal studies based on the purpose of current study. The aim of this study was to check nutritional management in patients having complications of liver cirrhosis. RESULTS: According to the guidelines, for the conservation of normal nutritional status of the malnourished patients’, energy should be provided 35 kcal/kg/day while to prevent hypoalbuminemia and maintain the protein stores in the body, 1.5 g/kg/day protein has been recommended. Carbohydrates and fats for cirrhosis patients are recommended 50% to 60% and 10% to 20% of the total dietary intake respectively. CONCLUSION: Initial identification and prevention of malnutrition have the probability to lead to better health outcomes, prevention of complications of the disease, and improving quality of life.

Valoración Antropométrica: Su Rol en El Diagnóstico Nutricional en Pacientes Con Cirrosis Hepática

“…Un estudio realizado por Hassan y col (29) con una muestra 101 pacientes calculando el IMC según los criterios de Campillo, reportaron que de acuerdo con la severidad de la enfermedad de cirrosis hepática, el Child A (n=22) con IMC= 26,9 ±6,7; en Child B (n=53) con IMC 26,5 ±5,7 y Child C (n=26) IMC 26,9 ±6,7, valores similares a los reportados en la presente investigación, donde se utilizó para la evaluación nutricional el índice de masa corporal calculado utilizando el peso seco de los pacientes (método rápido para la evaluación nutricional) (30), también el IMC validado por Campillo y col (19). Por otra parte, Shiraki y col (31) evaluaron 293 pacientes entre 2007 y 2011 reportando que el IMC de los pacientes fue de 23,1 ± 3,4 kg/m 2 , así también en pacientes sin ascitis, ni edema el IMC fue de 23,6 ± 3,6 kg/m 2 valores que difieren de la presente investigación.…”