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Nutritional support in hepatic encephalopathy.
Nutrition 1999; 15(3):220-8N

Abstract

Hepatic encephalopathy (HE) is a syndrome of global cerebral dysfunction resulting from underlying liver disease or portal-systemic shunting. HE can present as one of four syndromes, depending on the rapidity of onset of hepatic failure and the presence or absence of preexisting liver disease. The precise pathogenesis is unknown but likely involves impaired hepatic detoxification of ammonia as well as alterations in brain transport and metabolism of amino acids and amines. The etiology of malnutrition in hepatic failure is multifactorial. Nutritional deficits may be clinically manifest as marasmus or kwashiorkor, or both. Nutritional support in HE is directed toward reducing morbidity related to underlying malnutrition and concurrent disease. However, reaching nutritional goals is often complicated by protein and carbohydrate intolerance. The use of protein restriction in HE is controversial. Modified formulas that are supplemented in branched chain amino acids may be of value in patients who exhibit protein intolerance with standard feeding solutions or in patients who present with advanced degrees of encephalopathy.

Authors+Show Affiliations

Division of Critical Care Medicine, Cook County Hospital, Chicago, Illinois, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

10198918

Citation

Mizock, B A.. "Nutritional Support in Hepatic Encephalopathy." Nutrition (Burbank, Los Angeles County, Calif.), vol. 15, no. 3, 1999, pp. 220-8.
Mizock BA. Nutritional support in hepatic encephalopathy. Nutrition. 1999;15(3):220-8.
Mizock, B. A. (1999). Nutritional support in hepatic encephalopathy. Nutrition (Burbank, Los Angeles County, Calif.), 15(3), pp. 220-8.
Mizock BA. Nutritional Support in Hepatic Encephalopathy. Nutrition. 1999;15(3):220-8. PubMed PMID: 10198918.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutritional support in hepatic encephalopathy. A1 - Mizock,B A, PY - 1999/4/13/pubmed PY - 1999/4/13/medline PY - 1999/4/13/entrez SP - 220 EP - 8 JF - Nutrition (Burbank, Los Angeles County, Calif.) JO - Nutrition VL - 15 IS - 3 N2 - Hepatic encephalopathy (HE) is a syndrome of global cerebral dysfunction resulting from underlying liver disease or portal-systemic shunting. HE can present as one of four syndromes, depending on the rapidity of onset of hepatic failure and the presence or absence of preexisting liver disease. The precise pathogenesis is unknown but likely involves impaired hepatic detoxification of ammonia as well as alterations in brain transport and metabolism of amino acids and amines. The etiology of malnutrition in hepatic failure is multifactorial. Nutritional deficits may be clinically manifest as marasmus or kwashiorkor, or both. Nutritional support in HE is directed toward reducing morbidity related to underlying malnutrition and concurrent disease. However, reaching nutritional goals is often complicated by protein and carbohydrate intolerance. The use of protein restriction in HE is controversial. Modified formulas that are supplemented in branched chain amino acids may be of value in patients who exhibit protein intolerance with standard feeding solutions or in patients who present with advanced degrees of encephalopathy. SN - 0899-9007 UR - https://www.unboundmedicine.com/medline/citation/10198918/Nutritional_support_in_hepatic_encephalopathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899900798001919 DB - PRIME DP - Unbound Medicine ER -