Comparison of enteral feeding and total parenteral nutrition after liver transplantation

Wicks, Claire; Routley, Doug; Williams, Roger; Somasundaram, Siva G; Bjarnason, Ingvar; Potter, Dennis; Tan, Kelvin Bryan; Menzies, Ian S.

doi:10.1016/s0140-6736(94)92824-x

Cited by 189 publications

(79 citation statements)

References 24 publications

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“…31 The European Society for Clinical Nutrition and Metabolism created guidelines for meeting nutritional goals in patients with end-stage liver disease. 32 They It has been proposed that eating a late evening snack could alleviate the shift towards lipid oxidation by reducing the length of overnight fast.…”

Section: Malnutrition In Liver Cirrhosismentioning

confidence: 99%

The management of the patient with malnutrition: from evidence to clinical practice

Poggiano

Ciarla

Gnerre³

et al. 2017

Ital J Med

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Malnutrition can be defined as a state of nutrition in which a deficiency or excess (or imbalance) of energy, protein and other nutrients causes measurable adverse effects on tissue/body form (body shape, size, composition) body function and clinical outcome. Malnutrition is a highly prevalent condition in the acute hospital setting with studies reporting rates of approximately 40%. Malnutrition is associated with many adverse outcomes including depression of the immune system, impaired wound healing, muscle wasting, longer lengths of hospital stay and increased mortality. Unidentified malnutrition not only heightens the risk of adverse complications for patients but results in an increase in health care costs. This can be prevented if special attention is given to their nutritional care. For this reason, hospital and healthcare organizations should have a policy and a specific set of protocols for identifying patients at nutritional risk, leading to appropriate care plans. The objective of this monograph is to provide evidence-based recommendations for the proper management of malnutrition by multi-parametric analysis of the guidelines available to date.

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Section: Malnutrition In Liver Cirrhosismentioning

confidence: 99%

The management of the patient with malnutrition: from evidence to clinical practice

Poggiano

Ciarla

Gnerre³

et al. 2017

Ital J Med

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“…[46][47] Critics of TPN though argue that in addition to cost and catheter related sepsis it may lead to electrolyte and metabolic disturbances, gut barrier alteration and increased intestinal permeability. [48][49] the importance of enteral nutrition in severe acute pancreatitis has recently been emphasized. Contrary to popular belief enteral feeding delivered through naspgastric or nasojejunal tube has been shown to be safe and is preferable in patients with acute necrotising pancreatitis in absence of substantial ileus or duodenal obstruction.…”

Section: Prevention Of Infectionmentioning

confidence: 99%

Acute Severe Necrotising Pancreatitis Is Really a Surgical Challenge: An Overview

Choudhury¹

2015

jemds

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Necrotic pancreatitis is a severe form of acute pancreatitis where morbidity and mortality associated with this type of acute pancreatitis are comparatively higher especially when it is also infected. It is estimated to be around 10-24% whereas less than 1% is if in mild form. Despite relative less study, there has been a significant change in the management of acute necrotising pancreatitis over the past two decades. Although 75% to 80% of cases of acute pancreatitis is a mild disease without associate mortality it is important to identify the 20% to 25% of patients who are likely to develop severe disease associated with major complications and who would benefit from early intensive care monitoring and treatment. In recent years the treatment of acute necrotising pancreatitis has shifted away from early surgical debridement (Necrosectomy) to aggressive intensive medical care of multiple organ systems with specific criteria for operative and non-operative management. This review presents the current concepts with regards to diagnosis and management of acute necrotising pancreatitis including the variation of opinion in most critical aspects. Some of the issues addressed include the management of these patients in an intensive care/ therapy unit, the role of prophylactic antibiotics, requirement of nutrition, enteral and/or parenteral and pre-surgical resuscitative management, the role of CT scan and FNAC in diagnosing infection and finally the role of surgery.

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“…62 Other studies compared the efficacy and tolerability of early enteral feeding versus the total parenteral nutrition after LT. Enteral feeding was shown to be as effective as total parenteral nutrition at maintaining nutritional status, and had potential benefits reducing complications and costs. 63,64 An innovative approach has been proposed by Plank et al who showed an increase in the total body protein measured by neutron activation analysis in a small group of patients receiving an immunomodulatory oral supplementation before and immediately after LT. 65 Due to the small size of the study (15 treated and 17 controls receiving standard nutrition), the authors could not demonstrate any reduction in the number of infection episodes. No other studies have been performed to confirm these results in a larger number of patients.…”

Section: Journal Of Clinical and Experimental Hepatologymentioning

confidence: 99%

Nutritional Status and Liver Transplantation

Merli¹,

Giusto²,

Giannelli³

et al. 2011

Journal of Clinical and Experimental Hepatology

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Chronic liver disease has a profound effect on nutritional status and undernourishment is almost universally present in patients with end-stage liver disease undergoing liver transplantation. In the last decades, due to epidemiological changes, a trend showing an increase in patients with end-stage liver disease and associated obesity has also been reported in developed countries. Nutrition abnormalities may influence the outcome after transplantation therefore, the importance to carefully assess the nutritional status in the work-up of patients candidates for liver transplantation is widely accepted. More attention has been given to malnourished patients as they represent the greater number. The subjective global nutritional assessment and anthropometric measurements are recognized in current guidelines to be adequate in identifying those patients at risk of malnutrition. Cirrhotic patients with a depletion in lean body mass and fat deposits have an increased surgical risk and malnutrition may impact on morbidity, mortality and costs in the post-transplantation setting. For this reason an adequate calorie and protein intake should always be ensured to malnourished cirrhotic patient either through the diet, or using oral nutritional supplements or by enteral or parenteral nutrition although studies supporting the efficacy of nutritional supplementation in improving the clinical outcomes after transplantation are still scarce. When liver function is restored, an amelioration in the nutritional status is expected. After liver transplantation in fact dietary intake rapidly normalizes and fat mass is progressively regained while the recovery of muscle mass can be slower. In some patients unregulated weight gain may lead to over-nutrition and may favor metabolic disorders (hypertension, hyperglycemia, hyperlipidemia). This condition, defined as 'metabolic syndrome', may play a negative role on the overall survival of liver transplant patients. In this report we review data on nutrition and liver transplantation. © 2011 INASL

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Comparison of enteral feeding and total parenteral nutrition after liver transplantation

Cited by 189 publications

References 24 publications

The management of the patient with malnutrition: from evidence to clinical practice

The management of the patient with malnutrition: from evidence to clinical practice

Acute Severe Necrotising Pancreatitis Is Really a Surgical Challenge: An Overview

Nutritional Status and Liver Transplantation

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