HYPERALIMENTATION IN ALCOHOLIC HEPATITIS

Abstract

Enteral hyperalimentation in 4 patients with severe alcoholic hepatitis and anorexia increased spontaneous food intake, increased their N balance and the patients improved clinically. Seven patients with alcoholic hepatitis, who were clinically ill and able to eat only 410-1100 calories per day, were given a 900 mOsmolar/l parenteral hyperalimentation solution by a peripheral vein (P-900). The i.v. nutrition provided daily 51.6-77.4 g amino acids in addition to oral intake. All patients improved. None developed detectable encephalopathy after 16-42 days of P-900 therapy. Five additional patients had ascites and alcoholic hepatitis. The daily infusion of 2000 ml P-900 was not associated with hyponatremia, renal failure or encephalopathy in 4 of these 5 patients who improved and continued their diuresis. P-900 therapy was discontinued in one because of progressive hyponatremia. Over and above the maximum tolerable oral nutrition, i.v. nutrition can be effectively utilized by clinically ill, jaundiced patients with alcoholic hepatitis without precipitating encephalopathy or interference with standard therapy of ascites.