title: ESPEN Guidelines on Parenteral Nutrition: hepatology.
abstract: Parenteral nutrition (PN) offers the possibility to increase or to ensure nutrient intake in patients, in whom sufficient nutrition by oral or enteral alone is insufficient or impossible. Complementary to the ESPEN guideline on enteral nutrition of liver disease (LD) patients the present guideline is intended to give evidence-based recommendations for the use of PN in LD. For this purpose three paradigm conditions of LD were chosen: alcoholic steatohepatitis (ASH), liver cirrhosis and acute liver failure. The guideline was developed by an interdisciplinary expert group in accordance with officially accepted standards and is based on all relevant publications since 1985. The guideline was presented on the ESPEN website and visitors' criticism and suggestions were welcome and included in the final revision. PN improves nutritional state and liver function in malnourished patients with ASH. PN is safe and improves mental state in patients with cirrhosis and severe HE. Perioperative (including liver transplantation) PN is safe and reduces the rate of complications. In acute liver failure PN is a safe second-line option to adequately feed patients in whom enteral nutrition is insufficient or impossible.
authors.affiliation: Städtisches Klinikum, Dessau, Germany.
authors.forename: Mathias
authors.initials: M
authors.lastname: Plauth
authors.forename: Eduard
authors.initials: E
authors.lastname: Cabré
authors.forename: Bernard
authors.initials: B
authors.lastname: Campillo
authors.forename: Jens
authors.initials: J
authors.lastname: Kondrup
authors.forename: Giulio
authors.initials: G
authors.lastname: Marchesini
authors.forename: Tatjana
authors.initials: T
authors.lastname: Schütz
authors.forename: Alan
authors.initials: A
authors.lastname: Shenkin
authors.forename: Julia
authors.initials: J
authors.lastname: Wendon
mesh_terms: D000328:Adult; D002986:Clinical Trials as Topic; D004750:Enteral Nutrition; D005235:Fatty Liver, Alcoholic / Q000628:therapy; D006801:Humans; D008103:Liver Cirrhosis / Q000628:therapy; D008107:Liver Diseases / Q000150:complications / Q000628:therapy*; D017114:Liver Failure, Acute / Q000628:therapy; D016031:Liver Transplantation / Q000534:rehabilitation; D044342:Malnutrition / Q000628:therapy*; D008875:Middle Aged; D009752:Nutritional Status; D010288:Parenteral Nutrition / Q000592:standards; D011182:Postoperative Care; D055815:Young Adult