Effects of prolonged oral nutritional support in malnourished cirrhotic patients: results of a pilot study.
OBJECTIVE
The aim of this prospective study was to evaluate the acceptance and the effects of nutritional supplementation in malnourished ambulatory patients with liver cirrhosis.


METHODS
From June 1999 through June 2000, alcoholic cirrhotic patients with moderate to severe malnutrition as assessed with the Detsky index were included in the study. Patients were instructed to consume, in addition to their regular diet, a commercial solution that provided 500 kcal/day. Physical examination, dietary recalls and laboratory tests were performed at 1, 2 and 3 Month.


RESULTS
Twenty-nine patients with a mean age of 52 Years were included. The Child-Pugh grade was A in 6 patients, B in 14 and C in 8. Eighteen patients (62%) completed the 3 Month study protocol. Mean non-alcohol calorie intake increased significantly by 31% at 1 Month and by 48% at 3 Months. At the same time alcohol calorie intake decreased significantly by 68% and 77%, respectively. Subjective improvement in nutritional status was associated with significant improvement of mean Child-Pugh score (P=0.0007) and triceps skinfold thickness (P=0.005). The increase of mid-arm circumference was not significant.


CONCLUSIONS
This study showed that oral supplementation in ambulatory patients with liver cirrhosis is feasible and associated with a significant improvement of nutritional status and biological parameters including the Child-Pugh score. This benefit was associated with a concomitant reduction of alcohol intake.
Cunha
Lina
L
Service d'Hépato-Gastroentérologie et d'Assistance Nutritive, CHU La Milétrie.
Happi Nono
Marcel
M
Guibert
Anne Laure
AL
Nidegger
Delphine
D
Beau
Philippe
P
Beauchant
Michel
M
D000328:Adult; D000368:Aged; D019587:Dietary Supplements; D002149:Energy Intake; D005260:Female; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008297:Male; D044342:Malnutrition / Q000178:diet therapy* / Q000209:etiology; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D013997:Time Factors