The physiologic basis for nutritional support in hepatic failure.

Abstract

Hepatic failure is often perceived as a unidimensional progression from near normal clinical function (Child's class A) to overt clinical failure (Child's class C). As this view fails to distinguish between patients who are capable of using exogenous protein and those who cannot, it hinders the nutritional support team in determining protein supplementation. This report addresses the physiologic basis for variable findings in hepatic failure and proposes a simple definition of hepatic failure based upon ability to utilize amino acids.