Διατροφική Διαχείριση της Ηπατικής - TopicsExpress



          

Διατροφική Διαχείριση της Ηπατικής Εγκεφαλοπάθειας σε Κιρρωτικούς Ασθενείς. An expert panel commissioned by the International Society for Hepatic Encephalopathy and Nitrogen Metabolism has recommended that all patients with cirrhosis and hepatic encephalopathy should receive nutritional management similar to that for patients with cirrhosis but without hepatic encephalopathy. Specific recommendations from their consensus document are described below. Strongest recommendations: All patients should undergo baseline nutritional assessment as a part of management. (The authors acknowledged that no clinically practical, well-validated tools to assess nutrition are currently available.) Optimal daily energy intake should be 35 to 40 kcal/kg ideal body weight. Optimal daily protein intake should be 1.2 to 1.5 g/kg ideal body weight. Small meals evenly distributed throughout the day and a late-night snack of complex carbohydrate are ideal. Hyponatremia should always be corrected slowly. Recommendations with less certainty, but with moderate evidence: Encourage a diet rich in vegetable and daily protein. Branched-chain amino acid supplementation might allow recommended nitrogen intake to be maintained in patients intolerant of dietary protein. A 2-week course of a multivitamin could be justified in patients with decompensated cirrhosis. Encourage a diet containing 25 to 45 g of fiber daily. Avoid long-term treatment with manganese-containing nutritional formulations.
Posted on: Sat, 20 Jul 2013 01:48:37 +0000

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