ESPEN Guidelines on Parenteral Nutrition: Hepatology
Section snippets
Indication and time of PN in ASH
Immediate commencement of PN is indicated in ASH patients with moderate or severe malnutrition, who cannot be fed sufficiently either orally or enterally (A).
ASH patients who can be fed sufficiently either by oral or enteral route but who have to abstain from food temporarily (including nocturnal fasting!) for more than 12 h, should be given i.v. glucose at 2-3 g kg−1 d−1 (C). When this fasting period lasts longer than 72 h total PN is required (C).
Comments: The prognostic significance of a poor
Indication and timing of PN in cirrhosis
Immediate commencement of PN is indicated in moderately or severely malnourished cirrhotics who cannot be nourished sufficiently by either oral or enteral route (C).
Cirrhotics who can be fed sufficiently either by the oral or enteral route but who have to abstain from food temporarily (including nocturnal fasting!) for more than 12 h should be given i.v. glucose at 2–3 g kg−1 d−1 (C). When this fasting period lasts longer than 72 h total PN is required (C).
PN should be considered in patients with
Acute liver failure
Preliminary remarks: due to the substantial loss of liver cell function, acute liver failure (LF) is a serious condition characterised by profound metabolic dysfunction and is almost invariably complicated by multiple organ failure. Depending on the interval between the onset of jaundice and that of HE, hyperacute (interval < 8 days), acute (interval < 29 days) and subacute liver failure (interval 29–72 days) are distinguished.121 There is a more favourable prognosis in hyperacute than in acute or
Conflict of interest
Conflict of interest on file at ESPEN ([email protected]).
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