Nutrition for the Critically Ill Patient with Hepatic Failure

The liver is the largest metabolic organ in the human body, and this organ integrates a wide variety of complex biochemical processes including carbohydrate, fat, and protein metabolism, vitamin storage and activation, and detoxication and excretion of endogenous and exogenous waste products. Severe liver injury leads to a wide variety of metabolic derangements that proceed to the

Introduction .................................................................................................................................... 497 Acute Liver Failure ........................................................................................................................ 498 Clinical Features ............................................................................................................................ 498

Hepatic Encephalopathy ............................................................................................................ 499 Coagulopathy and Bleeding ...................................................................................................... 499 Infection .................................................................................................................................... 499

Multiple Organ Failure Syndrome ........................................................................................ 499 Metabolic Abnormalities ......................................................................................................500

Medical Management of Acute Liver Failure ................................................................................500 Chronic Liver Failure .....................................................................................................................500