Malnourished cirrhotic patient: what should we do?
| Autor: | Francesco Paolo Russo, Alberto Zanetto, S.S. Sciarrone, Giacomo Germani, Monica Pellone, Martina Gambato, Sara Battistella, Sarah Shalaby, Patrizia Burra, Marco Senzolo |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Vitamin
medicine.medical_specialty Screening assessment Sarcopenia Cirrhosis business.industry Endocrinology Diabetes and Metabolism Malnutrition Gastroenterology Cirrhotic patient musculoskeletal system medicine.disease Liver cirrhosis Calorie intake chemistry.chemical_compound Liver disease chemistry Internal Medicine Medicine Humans business Intensive care medicine |
| Popis: | Malnutrition and sarcopenia have a high prevalence in cirrhotic patients. Frailty generally overlaps with malnutrition and sarcopenia in cirrhosis, leading to increased morbidity and mortality. Rapid nutritional screening assessment should be performed in all patients with cirrhosis, and more specific tests for sarcopenia should be performed in those at high risk. The pathogenesis of malnutrition in cirrhosis is complex and multifactorial and it is not just due to reduction in protein and calorie intake. Nutritional management in malnourished patients with cirrhosis should be undertaken by a multidisciplinary team to achieve adequate protein/calorie intake. While the role of branched-chained amino acids remains somewhat contentious in achieving a global benefit of decreasing mortality- and liver-related events, these latter and vitamin supplements, are recommended for those with advanced liver disease. Novel strategies to reverse sarcopenia such as hormone supplementation, long-term ammonia-lowering agents and myostatin antagonists, are currently under investigation. Malnutrition, sarcopenia and frailty are unique, inter-related and multidimensional problems in cirrhosis which require special attention, prompt assessment and appropriate management as they significantly impact morbidity and mortality. |
| Databáze: | OpenAIRE |
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