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Journal of Parenteral and Enteral Nutrition
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Clinical Trial

Controlled Trial on Nutrition Supplementation in Outpatients With Symptomatic Alcoholic Cirrhosis

Sandra Hirsch, MD, MSC

Institute of Nutrition and Food Technology and Faculty of Medicine, University of Chile, Santiago, Department of Medicine, San Borja Arriaran Hospital, Santiago, Chile

Daniel Bunout, MD

Institute of Nutrition and Food Technology and Faculty of Medicine, University of Chile, Santiago, Department of Medicine, San Borja Arriaran Hospital, Santiago, Chile

Pia De La Maza, MD, MSc

Institute of Nutrition and Food Technology and Faculty of Medicine, University of Chile, Santiago, Department of Medicine, San Borja Arriaran Hospital, Santiago, Chile

Hernan Iturriaga, MD

Institute of Nutrition and Food Technology and Faculty of Medicine, University of Chile, Santiago, Department of Medicine, San Borja Arriaran Hospital, Santiago, Chile

Margarita Petermann, MSc

Institute of Nutrition and Food Technology and Faculty of Medicine, University of Chile, Santiago

Gloria Icazar

Institute of Nutrition and Food Technology and Faculty of Medicine, University of Chile, Santiago

Vivian Gattas

Institute of Nutrition and Food Technology and Faculty of Medicine, University of Chile, Santiago

Guillermo Ugarte, MD

Institute of Nutrition and Food Technology and Faculty of Medicine, University of Chile, Santiago, Department of Medicine, San Borja Arriaran Hospital, Santiago, Chile

A controlled trial on nutrition supplementation in ambulatory patients with decompensated alcoholic liver disease was carried out during 1 year. Fifty-one patients were studied; 26 were assigned to an experimental group receiving a daily supplement of 1000 kcal and 34 g of proteins given as a casein-based enteral nutrition product and 25 to a control group receiving one placebo capsule. Patients were examined in a special clinic once a month or more if required. Sixty-eight percent of patients admitted to alcohol ingestion or had alcohol in urine samples on at least one occasion. Dietary recalls showed a significantly higher protein and caloric intake in case patients subjects (p < .0001). Nine patients died during the study, three case patients and six control patients (p = NS). The frequency of hospitalizations was significantly less in the experimental group. This difference was attributed to a reduction in severe infections. Mid-arm circumference, serum albumin concentration, and hand grip strength improved earlier in case patients, although both groups had a significant improvement in these parameters. Bilirubin and aspartate aminotransferase decreased and prothrombin time increased significantly in both groups during the study period, without differences between groups. It is concluded that nutrition support decreases nutrition-associated complications in patients with alcoholic liver disease. (Journal of Parenteral and Enteral Nutrition 17:119-124, 1993)

Journal of Parenteral and Enteral Nutrition, Vol. 17, No. 2, 119-124 (1993)
DOI: 10.1177/0148607193017002119
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