NUTRITIONAL SUPPORT FOR FULMINANT HEPATITIS.

Estela Regina Ramos Figueira, Joel Avancini Rocha Filho, Lucas Souto Nacif, Luiz Carneiro D'Albuquerque, Dan Linetzky Waitzberg

fulminant hepatitis (FH) is associated with exacerbated hypercatabolism, hypoglycemia and hyperammonemia that are accompanied by the release of proinflammatory cytokines and catabolic hormones into the systemic circulation worsening patient's clinical condition. Nutritional support is a crucial element for the recovery of these patients. the aim of this review is to update Nutritional Support for Fulminant Hepatitis. the review was performed using electronic search on Medline-PubMed using Mesh-terms. there are not many data available on nutritional support to fulminant hepatitis or acute liver failure. Strategies for initial nutritional intervention are focused on the control of the previously described FH metabolic derangements, and should be individualized according to the severity of patient's clinical condition. Energy and protein can be provided in amounts of 25‑40 kcal/kg/day and 0.8-1.2 g/kg/day, respectively. Enteral nutrition therapy is indicated for patients with advancing encephalopathy or for those who cannot be properly fed orally. Euglycemia must be achieved and protein intake can be based on BCAA formulae. Lipids can be administered as energy supplementation with caution. Adequate nutrition therapy can potentially reduce morbidity and mortality of FH patients.