Title: A randomized clinical trial of supplementary parenteral nutrition in jaundiced alcoholic cirrhotic patients
Abstract: HepatologyVolume 6, Issue 2 p. 270-274 Original ArticleFree Access A randomized clinical trial of supplementary parenteral nutrition in jaundiced alcoholic cirrhotic patients Sylvie Naveau Dr., Corresponding Author Sylvie Naveau Dr. Service d'Hépato-Gastroentérologie, Hǒpital Antoine Béclère, 92141 Clamart, FranceService d'Hépato-Gastroentérologie, Hǒpital Antoine Béclère, 157, rue de la Porte de Trivaux, 92141 Clamart, France===Search for more papers by this authorGilles Pelletier, Gilles Pelletier Service des Maladies du Foie et de l'Appareil Digestif, Hǒpital de Bicětre, 94270 Le Kremlin-Bicětre, FranceSearch for more papers by this authorThierry Poynard, Thierry Poynard Service d'Hépato-Gastroentérologie, Hǒpital Antoine Béclère, 92141 Clamart, FranceSearch for more papers by this authorPierre Attali, Pierre Attali Service d'Hépato-Gastroentérologie, Hǒpital Antoine Béclère, 92141 Clamart, FranceSearch for more papers by this authorAlain Poitrine, Alain Poitrine Service d'Hépato-Gastroentérologie, Hǒpital Antoine Béclère, 92141 Clamart, FranceSearch for more papers by this authorCatherine Buffet, Catherine Buffet Service d'Hépato-Gastroentérologie, Hǒpital Antoine Béclère, 92141 Clamart, FranceSearch for more papers by this authorJean-Pierre Etienne, Jean-Pierre Etienne Service d'Hépato-Gastroentérologie, Hǒpital Antoine Béclère, 92141 Clamart, FranceSearch for more papers by this authorJean-Claude Chaput, Jean-Claude Chaput Service d'Hépato-Gastroentérologie, Hǒpital Antoine Béclère, 92141 Clamart, FranceSearch for more papers by this author Sylvie Naveau Dr., Corresponding Author Sylvie Naveau Dr. Service d'Hépato-Gastroentérologie, Hǒpital Antoine Béclère, 92141 Clamart, FranceService d'Hépato-Gastroentérologie, Hǒpital Antoine Béclère, 157, rue de la Porte de Trivaux, 92141 Clamart, France===Search for more papers by this authorGilles Pelletier, Gilles Pelletier Service des Maladies du Foie et de l'Appareil Digestif, Hǒpital de Bicětre, 94270 Le Kremlin-Bicětre, FranceSearch for more papers by this authorThierry Poynard, Thierry Poynard Service d'Hépato-Gastroentérologie, Hǒpital Antoine Béclère, 92141 Clamart, FranceSearch for more papers by this authorPierre Attali, Pierre Attali Service d'Hépato-Gastroentérologie, Hǒpital Antoine Béclère, 92141 Clamart, FranceSearch for more papers by this authorAlain Poitrine, Alain Poitrine Service d'Hépato-Gastroentérologie, Hǒpital Antoine Béclère, 92141 Clamart, FranceSearch for more papers by this authorCatherine Buffet, Catherine Buffet Service d'Hépato-Gastroentérologie, Hǒpital Antoine Béclère, 92141 Clamart, FranceSearch for more papers by this authorJean-Pierre Etienne, Jean-Pierre Etienne Service d'Hépato-Gastroentérologie, Hǒpital Antoine Béclère, 92141 Clamart, FranceSearch for more papers by this authorJean-Claude Chaput, Jean-Claude Chaput Service d'Hépato-Gastroentérologie, Hǒpital Antoine Béclère, 92141 Clamart, FranceSearch for more papers by this author First published: March/April 1986 https://doi.org/10.1002/hep.1840060219Citations: 73AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Abstract Between March 1982 and September 1983, 40 inpatients (25 men and 15 women, mean age 53 years) with alcoholic cirrhosis and total serum bilirubin ⩾5 mg per dl were studied. Those with hepatocellular carcinoma, renal failure, hyponatremia, septicemia, spontaneous bacterial peritonitis, gastrointestinal bleeding, and hepatic coma were excluded. Patients were studied for 28 days. The two groups were offered an oral diet containing 40 kcal per kg per day. Patients in the supplementary parenteral nutrition group received 40 kcal per kg per day and 200 mg nitrogen per kg per day using a central catheter. The major endpoint was total serum bilirubin on Day 28. On admission, serum bilirubin was not significantly different in the two groups: oral group, 12.5 ± 6.6 mg per dl; supplementary parenteral nutrition group, 12.3 ± 8.5 mg per dl. On Day 28, serum bilirubin was lower in the supplementary parenteral nutrition group (2.5 ± 1.4 mg per dl) than in the oral group (4.1 ± 2.2 mg per dl) (p < 0.02). Serum bilirubin was also lower in the supplementary parenteral nutrition group than in the oral group on Days 7, 14and 21 (p < 0.05). Analysis of covariance, considering serum bilirubin on admission and at randomization and time between admission and randomization, confirmed these results. On Day 28, anthropometric parameters, serum transferrin, prealbumin and retinol-binding protein were higherin the supplementary parenteral nutrition group, but the differences were not significant. Serum albumin was significantly lower in the supplementary parenteral nutrition group. The incidence of encephalopathy and sepsis was not significantly different between the two groups. References 1 Nasrallah SM, Galambos JT. Amino acid therapy of alcoholic hepatitis. Lancet 1980; 2: 1276– 1277. 2 Poynard T, Zourabichvili O, Hilpert G, et al. Prognostic value of total serum bilirubin/γ-glutamyl transpeptidase ratio in cirrhotic patients. Hepatology 1984; 4: 324– 327. 3 Frisancho AR. New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr 1981; 34: 2540– 2545. 4 Diehl AM, Boitnott JM, Herlong HF, et al. Effect of parenteral amino acid supplementation in alcoholic hepatitis. Hepatology 1985; 5: 57– 63. 5 Odell GB, Cukier JO, Ostrea EM, et al. The influence of fatty acids on the binding of bilirubin to albumin. J Lab Clin Med 1977; 89: 295– 307. 6 Burckar T. The effect of two intravenous fat emulsions and their components on bilirubin binding to albumin. Am J Clin Nutr 1982; 36: 521– 526. 7 Michel H, Raynaud A, Nalet B, et al. Tolerance des cirrhotiques aux lipides intraveineux. Proceedings of the International Congress on Parenteral Nutrition, Montpellier, 1974: 131– 137. 8 Rossner S, Johansson C, Walldius G, et al. Intralipid clearance and lipoprotein pattern in men with advanced alcoholic liver cirrhosis. Am J Clin Nutr 1979; 32: 2022– 2026. 9 Macfie J, Smith RC, Hill GL. Glucose or fat as a non protein energy source. A controlled clinical trial in gastroenterological patients requiring intravenous nutrition. Gastroenterology 1981; 80: 103– 107. 10 Yeung CK, Smith RC, Hill GL. Effect of an elemental diet on body composition. A comparison with intravenous nutrition. Gastroenterology 1979; 77: 652– 657. 11 Casagrande JT, Pike MC, Smith PG. An improved approximate formula for calculating sample sizes for comparing two binomial distributions. Biometrics 1978; 34: 483– 486. Citing Literature Volume6, Issue2March/April 1986Pages 270-274 ReferencesRelatedInformation