Assessment of nutritional status of the cirrhotic patients on enteral and parenteral feeding

Abstract

Background: Cirrhosis is an irreversible disease that replaces healthy tissues with scar tissues. According to the Pakistan Medical Research Council’s national general population survey (2008–2014), the ratio of cirrhosis was 4.8% among the population. Objectives: To assess the nutritional status of cirrhotic patients on enteral and parenteral nutrition and to assess the degree of malnutrition among cirrhotic patients. Methods: A cross-sectional study was conducted at Shalamar and Shiekh Zayed Hospitals of Lahore from January–April 2017. The convenient sampling technique was used. Inclusion criteria were the patients with decompensated liver cirrhosis, whereas compensated patients were excluded from the study. Data were collected through the patient’s file, nurse’s, and dietitian’s notes. The nutritional status of participants was assessed based on socio-demographic characteristics, anthropometric measurements, biochemical assessment, clinical signs, and dietary recall. Variables were categorized and compared to observe the level of significance in enteral and parenteral nutrition. SPSS version 22 was used to analyze data. Results: Patients on parenteral nutrition had a higher ratio of malnutrition with a significant Child–Pugh score—61.8% of patients belonged to Class C and 35.3% Class B, while in enteral support, 7.3% belonged to Class C and 43.9% patients belonged to Class B ( p-value = 0.000). There was a definite relationship observed in the route of intake and malnutrition among cirrhotic patients. Conclusion: Enteral route of nutrition is an effective and the safest way to provide appropriate nutrients according to the patient’s demands.

<span>T&Igrave;NH TRẠNG DINH DƯỠNG CỦA NGƯỜI BỆNH NAM XƠ GAN, RỐI LOẠN T&Acirc;M THẦN TẠI BỆNH VIỆN T&Acirc;M THẦN TH&Aacute;I B&Igrave;NH NĂM 2022</span>

“…Kết quả này tương đồng với kết quả nghiên cứu của tác giả Nguyễn Thị Hồng Nhung [6] và cộng sự trên 124 người bệnh mắc viêm gan tại khoa Nội tổng hợp, bệnh viện đa khoa Thái Bình với tỷ lệ 71,8% người bệnh nghiên cứu không có nguy cơ mắc SDD theo SGA. Tuy nhiên, kết quả nghiên cứu của chúng tôi lại thấp hơn kết quả trong nghiên cứu của tác giả Nguyễn Ngọc Khánh [9] với tỷ lệ người bệnh có nguy cơ cao mắc SDD lên tới 22,1%; cá biệt, nghiên cứu của tác giả Mahwish Aslam [10]…”

Nutrition Therapy in Critically Ill Patients with Liver Disease: A Narrative Review

“…In addition, the use of PN should be considered early on (i.e., day 3-4 of ICU admission) to achieve nutritional targets and avoid the occurrence or development of malnutrition [24]. Older patients (i.e., >50 years old) under PN more frequently have ascites and a positive fluid balance; however, these patients usually exhibit a higher risk of malnutrition compared with patients on EN [71]. Physicians should be aware of the detrimental effects that a positive fluid balance caused by PN may have on gastrointestinal function, which ultimately are related to worse outcomes [72].…”