Premium
Enteral Energy and Macronutrients in End‐Stage Liver Disease
Author(s) -
Mouzaki Marialena,
Ng Vicky,
Kamath Binita M.,
Selzner Nazia,
Pencharz Paul,
Ling Simon C.
Publication year - 2014
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607114522488
Subject(s) - malnutrition , medicine , parenteral nutrition , intensive care medicine , protein–energy malnutrition , cirrhosis , liver disease , comorbidity , enteral administration , liver transplantation , disease , stage (stratigraphy) , model for end stage liver disease , pediatrics , transplantation , paleontology , biology
Protein‐energy malnutrition is the most common comorbidity affecting adults and children with end‐stage liver disease. Despite clear evidence linking malnutrition to poor outcomes before and after liver transplantation, nutrition rehabilitation is often inadequately emphasized in the clinical management of these patients. The primary aim of this review is to synthesize the available evidence supporting the current clinical guidelines on enteral nutrition support and, more important, to highlight the lack of evidence behind much of what is considered “standard of care” for the nutrition management of patients with cirrhosis. In addition, the mechanisms of malnutrition are reviewed, the limitations of tools used to assess body composition in this setting are discussed, and the differences in macronutrient metabolism between healthy subjects and patients with end‐stage liver disease are explained. A summary of recommendations is provided.