Nutritional support in hepatic encephalopathy

Nutrition

Volumn 15, Issue 3, 1999, Pages 220-228

  Mizock, Barry A ^a  

^a ROSALIND FRANKLIN UNIVERSITY OF MEDICINE AND SCIENCE   (United States)

Author keywords

Branched chain amino acids; Hepatic encephalopathy; Liver disease; Nutritional support

Indexed keywords

AMMONIA; BRANCHED CHAIN AMINO ACID; NUTRIHEP; UNCLASSIFIED DRUG; VEGETABLE PROTEIN; VITAMIN; ZINC; ZINC ACETATE; ZINC SULFATE;

CARBOHYDRATE INTOLERANCE; CLINICAL TRIAL; ENTERIC FEEDING; HEPATIC ENCEPHALOPATHY; HUMAN; KWASHIORKOR; LIVER FAILURE; MALNUTRITION; MARASMUS; META ANALYSIS; NUTRITIONAL SUPPORT; PATHOGENESIS; PRACTICE GUIDELINE; PRIORITY JOURNAL; PROTEIN CALORIE MALNUTRITION; PROTEIN DIET; PROTEIN INTOLERANCE; PROTEIN RESTRICTION; REVIEW; VITAMIN DEFICIENCY; ZINC DEFICIENCY;

AMINO ACIDS; AMMONIA; CARBOHYDRATE METABOLISM; DIETARY PROTEINS; HEPATIC ENCEPHALOPATHY; HUMANS; LIPID METABOLISM; LIVER FAILURE; NUTRITION DISORDERS; NUTRITIONAL SUPPORT; PROTEINS;

EID: 0033103666     PISSN: 08999007     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0899-9007(98)00191-9     Document Type: Review

References (134)

1. Adler M., Verset D., Bouhdid H., et al. Prognostic evaluation of patients with parenchymal cirrhosis proposal of a new simple score . J Hepatol. 26:1997;642.
2. Matuschak G.M. Lung-liver interactions in sepsis and multiple organ failure syndrome. Clin Chest Med. 17:1996;83.
3. Boermeester M.A., Houdijk A.P.J., Meyer S., et al. Liver failure induces a systemic inflammatory response. Am J Pathol. 147:1995;1428.
4. Sherlock S. Hepatic encephalopathy. Sherlock S., Diseases of the liver and biliary system. 7th ed. 1985;91 Blackwell, London.
5. Quero J.C., Schalm S.W. Subclinical hepatic encephalopathy. Semin Liver Dis. 16:1996;321.
6. Mullen K.D., Gacad R. Hepatic encephalopathy. Gastroenterologist. 4:1996;188.
7. Conn H.O., Leevy C.M., Vlahcevic Z.R., et al. Comparison of lactulose and neomycin in the treatment of chronic portal-systemic encephalopathy. Gastroenterology. 72:1997;573.
8. Jeppsson B., Freund H.R., Gimmon Z., et al. Blood-brain barrier derangement in sepsis cause of septic encephalopathy? Am J Surg. 141:1981;136.
9. Mizock B.A., Dubin A., Rackow E.C., Burke G.S. Elevated cerebrospinal fluid glutamine in septic encephalopathy [letter]. J Clin Gastroenterol. 11:1989;362.
10. Jaikin A., Agrest A. Cerebrospinal fluid glutamine concentration in patients with chronic hypercapnia. Clin Sci. 36:1969;11.
11. Butterworth R.F. The neurobiology of hepatic encephalopathy. Semin Liver Dis. 16:1996;235.
12. Hindfelt B., Plum F., Duffy T.E. Effects of acute ammonia intoxication on cerebral metabolism in rats with portacaval shunts. J Clin Invest. 59:1977;386.
13. Noremberg M.D. The role of astrocytes in hepatic encephalopathy. Neurochem Pathol. 6:1987;13.
14. Sherlock S., Dooley J. Hepatic encephalopathy. Sherlock S., Dooley J., Diseases of the liver and biliary system. 10th ed. 1997;87 Blackwell Science, London.
15. Schafer D.F., Jones E.A. Hepatic encephalopathy and the gamma-aminobutyric acid neurotransmitter system. Lancet. 1:1982;18.
16. Thompson J.S., Schafer D.F., Schafer G.J., Hodgson P.E. Gamma-aminobutyric acid plasma levels and brain binding in Eck fistula dogs. J Surg Res. 38:1985;143.
17. Levy L.J., Losowsky M.S. Plasma gamma aminobutyric acid concentrations provide evidence of different mechanisms in the pathogenesis of hepatic encephalopathy in acute and chronic liver disease. Hepatogastroenterology. 36:1989;494.
18. Schafer D.F., Fowler J.M., Munson P.J., et al. Gamma aminobutyric and benzodiazepine receptors in an animal model of fulminant hepatic failure. J Lab Clin Med. 102:1983;870.
19. Scollo-Lavizarri G., Steinmann E. Reversal of hepatic coma by benzodiazepine antagonist (Ro15-1788). Lancet. 1:1985;1324.
20. Bansky G., Meier P.J., Ziegler W.H., et al. Reversal of hepatic encephalopathy by benzodiazepine antagonist (Ro15-1788). Lancet. 1:1985;1324.
21. Hawkins R.A., Mans A.M. Brain metabolism in encephalopathy caused by hyperammonemia. Adv Exp Med Biol. 368:1994;11.
22. Hawkins R.A., Jessey J., Mans A.M., Chedid A., DeJoseph M.R. Neomycin reduces the intestinal production of ammonia from glutamine. Adv Exp Med Biol. 368:1995;125.
23. Lockwood A.H., Yap E.W.H., Wong W.H. Cerebral ammonia metabolism in patients with severe liver disease and minimal hepatic encephalopathy. J Cereb Blood Flow Metab. 11:1991;337.
24. Hourani B.T., Hamlin E.M., Reynolds T.B. Cerebrospinal fluid glutamine as a measure of hepatic encephalopathy. Arch Intern Med. 127:1971;1033.
25. Gilon E., Szeinberg A., Tauman G., et al. Glutamine estimation in cerebrospinal fluid in cases of liver cirrhosis and hepatic coma. J Lab Clin Med. 53:1959;714.
26. Vergara F., Plum F., Duffy T.E. Alpha-ketoglutaramate increased concentrations in the cerebrospinal fluid of patients in hepatic coma . Science. 183:1974;81.
27. Hawkins R.A., Jessy J. Hyperammonaemia does not impair brain function in the absence of net glutamine synthesis. Biochem J. 277:1991;697.
28. Takahashi H., Koehler R., Brudiolos S.W., Traystman R.J. Inhibition of brain glutamine accumulation prevents cerebral edema in hyperammonemic rats. Am J Physiol. 261:1991;H825.
29. Theoret Y., Bossu J.L. Effects of ammonium salts on synaptic transmission in the rat hippocampal slice. Neuroscience. 14:1985;807.
30. DeKnegt R.J., Schalm S.W., VanDerRijt C.C.D., et al. Extra-cellular brain glutamate during acute liver failure and during acute hyperammonemia simulating acute liver failure an experimental study based on in vivo brain dialysis . J Hepatol. 20:1994;19.
31. Huo Z., Neary J.T., Petito C.K., Norenberg M.D. The glutamate transporter GLT-1 is downregulated in hyperammonemia and acute liver failure. Soc Neurosci Abstr. 21:1995;1081.
32. 3H] glutamate binding sites in rat brain following portacaval anastamosis. J Neurochem. 55:1990;386.
33. Fischer J.E., Baldessarini J.R. False neurotransmitters and hepatic failure. Lancet. 2:1971;75.
34. James J.H., Jeppson B., Ziparo V., Fischer J.E. Hyperammonaemia, plasma aminoacid imbalance, and blood-brain aminoacid transport a unified theory of portal-systemic encephalopathy . Lancet. 2:1979;772.
35. James J.H., Cangiano C., Cardelli-Cangiano P., Fischer J.E. Glutamine links hyperammonemia and neurotransmitter derangements in portal systemic shunting. Gastroenterology. 78:1980;1308.
36. David J.C., Dairman W., Undenfriend S. Decarboxylation to tyramine a major route of tyrosine metabolism in mammals . Proc Natl Acad Sci USA. 72:1974;1171.
37. Mans A.M., Biebuyck J.F., Saunders S.J., Kirsch R.E., Hawkins R.A. Tryptophan transport across the blood-brain barrier during acute hepatic failure. J Neurochem. 33:1979;409.
38. Mans A.M., Biebuyck J.F., Hawkins R.A. Ammonia selectively stimulates neutral amino acid transport across blood-brain barrier. Am J Physiol. 245:1983;C74.
39. Lee W.J., Hawkins R.A., Vina J.R., Peterson D.R. Glutamine and glutamate transport by the blood-brain barrier a possible mechanism for nitrogen removal . Am J Physiol. 274:1998;C1101.
40. Knudsen G.M., Schmidt J., Almdal T., Paulson O.B., Vilstrup H. Passage of amino acids and glucose across the blood-brain barrier in patients with hepatic encephalopathy. Hepatology. 17:1993;987.
41. Hawkins R.A., Mans A.M., Biebuyck J.F. Changes in brain metabolism in hepatic encephalopathy. Neurochem Path. 6:1987;35.
42. Borg J., Warter J.M., Schlienger J.L., et al. Neurotransmitter modifications in human cerebro-spinal fluid and serum during hepatic encephalopathy. J Neurol Sci. 57:1982;343.
43. Rossi-Fanelli F., Freund H., Krause R., et al. Induction of coma in normal dogs by the infusion of aromatic amino acids and its prevention by the addition of branched-chain amino acids. Gastroenterology. 83:1982;664.
44. Zieve L., Olsen R.L. Can hepatic coma be caused by a reduction of brain noradrenaline or dopamine? Gut. 18:1977;688.
45. Bergeron M., Reader T.A., Pomier Layrargues G., Butterworth R.F. Monoamines and metabolites in autopsied brain tissue from cirrhotic patients with hepatic encephalopathy. Neurochem Res. 14:1989;853.
46. Young S.N., Lal S., Feldmuller F., Aranoff A., Martin J.B. Relationships between tryptophan in serum and CSF and 5-hydroxyindoleacetic acid in CSF of man effects of cirrhosis of the liver and probenecid administration . J Neurol Neurosurg Psychiatry. 38:1975;322.
47. Young S.N., Lal S. CNS tryptamine metabolism in hepatic coma. J Neural Trans. 47:1980;153.
48. 3H] tryptamine binding sites in autopsied brain tissue from cirrhotic patients with hepatic encephalopathy. J Neurochem. 62:1994;621.
49. Record C.O. Glucose and insulin metabolism in cirrhosis. Adv Exp Med Biol. 420:1997;229.
50. Zawalich W.S., Sawalich K.C. Interleukin-1 is a potent stimulator of islet insulin secretion and phosphoinositide hydrolysis. Am J Physiol. 256:1989;E19.
51. Andus T., Holstege A. Cytokines and the liver in health and disease effects on liver metabolism and fibrogenesis . Acta Gastroentol Belg. 57:1994;236.
52. Letiexhe M.R., Scheen A.J., Gerard P.L., et al. Insulin secretion, clearance, and action on glucose metabolism in cirrhotic patients. J Clin Endocrinol Metab. 77:1993;1263.
53. Gelding S.V., Alberti K.G.M.M., Johnston D.G. The liver and the endocrine system. Millward-Sadler G.H., Wright R., Arthur M.J.P., Wright's liver and biliary disease. 1993;175 WB Saunders, London.
54. Lin H.C., Yang C.M., Hou M.C., et al. Hyperglucagonaemia in cirrhotic patients and its relationship to the severity of cirrhosis and haemodynamic values. J Gastroenterol Hepatol. 11:1996;422.
55. Kabadi U.M. Is hepatic glycogen content a regulator of glucagon secretion? Metabolism. 41:1992;113.
56. Blomsma M.C., de Knegt R.J., Dullaart R.P.F., Jansen P.L.M. Insulin-like growth factor-I in liver cirrhosis. J Hepatol. 27:1997;1133.
57. Alberti K.G.M.M., Taylor R., Johnston D.G. Carbohydrate metabolism in liver disease. Millward-Sadler G.H., Wright R., Arthur M.J.P., Wright's liver and biliary disease. 1993;44 WB Saunders, London.
58. Morgan M.Y. Nutrition and the liver. Millward-Sadler G.H., Wright R., Arthur M.J.P., Wright's liver and biliary disease. 1993;107 WB Saunders, London.
59. McCallum R.E. Hepatocyte-Kupffer cell interactions in the inhibition of hepatic gluconeogenesis by bacterial endotoxin. Majde J.D., Person R.J., Pathophysiological effects of endotoxins at the cellular level. 1981;99 Alan R. Liss, New York.
60. Muller M.J., Pirlich M., Balks H.J., Selberg O. Glucose intolerance in liver cirrhosis role of hepatic and non-hepatic influences . J Clin Chem Clin Biochem. 32:1994;749.
61. Muller M.J., Willmann O., Rieger A., et al. Mechanism of insulin resistance associated with liver cirrhosis. Gastroenterology. 102:1992;2033.
62. Selberg O., Buchert W., v. d. Hoff J, et al. Insulin resistance in liver cirrhosis. J Clin Invest. 91:1993;1897.
63. Petrides A.S., Groop L.C., Riely C.A., DeFronzo R.A. The effect of physiologic hyperinsulinemia on glucose and lipid metabolism in cirrhosis. J Clin Invest. 88:1991;561.
64. Owen O.E., Reichle F.A., Mozzoli M.A., et al. Hepatic, gut, and renal substrate flux rates in patients with hepatic cirrhosis. J Clin Invest. 68:1981;240.
65. Cerra F.B., Siegel J.H., Border J.R., Wiles J., McMenamy R.R. The hepatic failure of sepsis cellular versus substrate . Surgery. 86:1979;409.
66. Cabre E., Nunez M.C., Gonzalez-Huix F., et al. Clinical and nutritional factors predictive of plasma lipid unsaturation deficiency in advanced liver cirrhosis a logistic regression analysis . Am J Gastroenterol. 88:1993;1738.
67. Cabre E., Abad-Lacruz A., Nunez M.C., et al. The relationship of plasma polyunsaturated fatty acid deficiency with survival in advanced liver cirrhosis multivariate analysis . Am J Gastroenterol. 88:1993;718.
68. Muscaritoli M., Cangiano C., Cascino A., et al. Exogenous lipid clearance in compensated liver cirrhosis. JPEN. 10:1986;599.
69. Swart G.R., van den Berg J.W.O., van Vuure J.K., et al. Minimum protein requirements in liver cirrhosis determined by nitrogen balance measurements at three levels of protein intake. Clin Nutr. 8:1989;329.
70. Swart G.R., van den Berg J.W.O., Wattinema J.L., et al. Elevated protein requirements in cirrhosis of the liver investigated by whole body protein turnover studies. Clin Sci. 75:1988;101.
71. Nielsen K., Kondrup J., Martinsen L., Stilling B., Wikman B. Nutritional assessment and adequacy of dietary intake in hospitalized patients with alcoholic liver disease. Br J Nutr. 69:1993;665.
72. Fischer J.E. Efficacy of branched-chain amino acids in the treatment of hepatic encephalopathy. Capocaccia L., Fischer J.E., Rossi-Fanelli F., Hepatic encephalopathy in chronic liver failure. 1984;311 Plenum Press, New York.
73. Rosen H.M., Yoshimura N., Hodgman J.M., et al. Plasma amino acid patterns in hepatic encephalopathy of differing etiology. Gastroenterology. 72:1977;483.
74. Charlton M.R. Branched chains revisited. Gastroenterology. 111:1996;252.
75. Marsano L., McClain C.J. Nutrition and alcoholic liver disease. JPEN. 15:1991;337.
76. Lautz H.U., Selberg O., Korber J., Burger M., Muller M.J. Protein-calorie malnutrition in liver cirrhosis. Clin Invest. 70:1992;478.
77. Shaw B.W., Wood P., Gordon R.D. Influence of selected patient variables and operative blood loss on six month survival following liver transplantation. Semin Liver Dis. 5:1985;385.
78. Merli M., Riggio O., Dally L. Does malnutrition affect survival in cirrhosis? Hepatology. 23:1996;1041.
79. Moller S., Bendtsen F., Christensen E., Henriksen J.H. Prognostic variables in patients with cirrhosis and oesophageal varices without prior bleeding. J Hepatol. 21:1994;940.
80. Casafont F., Sanchez E., Martin L., Aguero J., Romero F.P. Influence of malnutrition on the prevalence of bacterial translocation and spontaneous bacterial peritonitis in experimental cirrhosis in rats. Hepatology. 25:1997;1334.
81. Sourkes T.L. Tryptophan in hepatic coma. J Neural Trans. 14:(suppl):1978;79.
82. Kearns P.J., Young H., Garcia G., et al. Accelerated improvement of alcoholic liver disease with enteral nutrition. Gastroenterology. 102:1992;200.
83. Cabre E., Gonzalez-Huix F., Abad-Lacruz A., et al. Effect of total enteral nutrition on the short-term outcome of severely malnourished cirrhotics. Gastroenterology. 98:1990;715.
84. Bunout D., Aicardi V., Hirsch S., et al. Nutritional support in hospitalized patients with alcoholic liver disease. Europ J Clin Nutr. 43:1989;615.
85. Naveau S., Pelletier G., Pyonard T., et al. A randomized clinical trial of supplementary parenteral nutrition in jaundiced alcoholic cirrhotic patients. Hepatology. 6:1986;1986.
86. Naylor C.D., O'Rourke K., Detsky A.S., Baker J.P. Parenteral nutrition with branched-chain amino acids in hepatic encephalopathy a meta-analysis . Gastroenterology. 97:1989;1033.
87. Dersimonian R. Parenteral nutrition with branched-chain amino acids in hepatic encephalopathy meta-analysis . Hepatology. 11:1990;1083.
88. Rossi Fanelli F., Cangiano C. Branched-chain amino acids in chronic liver failure good friends or hated enemies? Nutrition. 6:1990;414.
89. Berlin J.A., Chalmers T.C. Meta-analysis of branched-chain amino acids in hepatic encephalopathy. Gastroenterology. 97:1989;1043.
90. Guglielmi F.W., Contento F., Laddaga L., Panella C., Francavilla A. Bioelectric impedance analysis experience with male patients with cirrhosis . Hepatology. 13:1991;892.
91. Rosen H.M., Soeters P.B., James J.H., Hodgman J., Fischer J.E. Influences of exogenous intake and nitrogen balance on plasma and brain aromatic amino acid concentrations. Metabolism. 27:1978;393.
92. Swart G.R., Van den Berg J.W.O., Wattimena J.L., et al. Elevated protein requirements in cirrhosis of the liver investigated by whole body protein turnover studies. Clin Sci. 75:1988;101.
93. O'Keefe S.J.D., Abraham R., El-Zayadi A., et al. Increased plasma tyrosine concentrations in patients with cirrhosis and fulminant hepatic failure associated with increased plasma tyrosine flux and reduced hepatic oxidation capacity. Gastroenterology. 81:1981;1017.
94. Mullen K.D., Weber F.L. Role of nutrition in hepatic encephalopathy. Semin Liver Dis. 11:1991;292.
95. Bernard M., Forlaw L. Complications and their prevention. Rombeau J.L., Caldwell M.D., Enteral and tube feeding. 1984;563 WB Saunders, Philadelphia.
96. Isobe H., Sakai H., Satoh M., et al. Delayed gastric emptying in patients with liver cirrhosis. Dig Dis Sci. 39:1994;983.
97. Van Thiel D.H., Fagiuoli S., Wright H.I., et al. Gastrointestinal transit in cirrhotic patients effect of hepatic encephalopathy and its treatment . Hepatology. 19:1994;67.
98. Mullen K.D., Gacad R. Pathogenetic mechanisms of acute hepatic encephalopathy. New Horizons. 2:1994;505.
99. Uribe M., Marquez M.A., Ramos G.G., et al. Treatment of chronic portal-systemic encephalopathy with vegetable and animal protein diets. Dig Dis Sci. 27:1982;1109.
100. Bianchi G.P., Marchesini G., Fabbri A., et al. Vegetable versus animal protein diet in cirrhotic patients with chronic encephalopathy a randomized cross-over comparison . J Intern Med. 233:1993;385.
101. Greenberger N.J., Carley J., Schenker S., et al. Effect of vegetable and animal protein diets in chronic hepatic encephalopathy. Am J Dig Dis. 22:1977;845.
102. Klein S., Kinney J., Jeejeebhoy K., et al. Nutrition support in clinical practice review of published data and recommendations for future research directions . JPEN. 21:1997;133.
103. Fischer J.E. Branched-chain-enriched amino acid solutions in patients with liver failure an early example of nutritional pharmacology . JPEN. 14:(suppl):1990;249S.
104. Rossi-Fanelli F., Angelico M., Cangiano C., et al. Effect of glucose and/or branched chain amino acid imbalance in chronic liver failure. JPEN. 5:1981;414.
105. Cerra F.B., Mazuski J., Teasley K., et al. Nitrogen retention in critically ill patients is proportional to the branched chain amino acid load. Crit Care Med. 11:1983;775.
106. Mans A.M., Biebuyck J.F., Davis D.W., Hawkins R.A. Portacaval anastomosis brain and plasma metabolite abnormalities and the effect of nutritional therapy . J Neurochem. 43:1984;697.
107. Rigotti P., Jonung T., James J.H., et al. Infusion of branched-chain amino acids and ammonium salts in rats with portacaval shunts. Arch Surg. 120:1985;1290.
108. Cerra F.B., Cheung N.K., Fischer J.E., et al. A multicenter trial of branched chain enriched amino acid infusion (F080) in hepatic encephalopathy [abstract]. Hepatology. 2:1982;699.
109. Naylor C.D., Detsky A.S., Baker J.P., et al. Role of parenteral nutrition in inflammatory bowel disease, acute renal failure, and hepatic encephalopathy. Int J Tech Assess Health Care. 6:1990;655.
110. Fabbri A., Magrini N., Bianchi G., Zoli M., Marchesini G. Overview of randomized clinical trials of oral branched-chain amino acid treatment in chronic hepatic encephalopathy. JPEN. 20:1996;159.
111. Morgan M.Y. The treatment of chronic hepatic encephalopathy. Hepatol Gastroenterol. 38:1991;377.
112. Plauth M., Merli M., Kondrup J., et al. ESPEN guidelines for nutrition in liver disease and transplantation. Clin Nutr. 16:1997;43.
113. Muller M.J., Lautz H.U., Plogmann B., et al. Energy expenditure and substrate oxidation in patients with cirrhosis the impact of cause, clinical staging and nutritional state . Hepatology. 15:1992;782.
114. Boari S., Marradi C., Chiara O., Bevilacqua G., Nespoli A. Energy expenditure in cirrhotic patients. Kleinberger G., Ferenci P., Riederer P., Thaler H., Advances in hepatic encephalopathy and urea cycle diseases. 1984;674 Karger, Basel, Switzerland.
115. Fischer G.W., Hunter K.W., Wilson S.R., Mease A.D. Diminished bacterial defences with Intralipid. Lancet. 2:1980;819.
116. Muller J.M., Keller H.W., Brenner U., Walter M., Holzmuller W. Indications and effects of preoperative parenteral nutrition. World J Surg. 10:1986;53.
117. Negro F., Cerra F.B. Nutritional monitoring in the ICU rational and practical application . Crit Care Clin. 4:1988;559.
118. Bernardini P., Fischer J.E. Amino acid imbalance and hepatic encephalopathy. Ann Rev Nut. 2:1982;419.
119. Glynn M.J., Powell-Tuck J., Reaveley D.A., Murray-Lyon I.M. High lipid parenteral nutrition improves portasystemic encephalopathy. JPEN. 12:1988;457.
120. Muller M.J. Malnutrition in cirrhosis. J Hepatol. 23:(suppl 1):1995;31.
121. Morgan M.Y., Bolton C.H., Morris J.S., et al. Medium-chain triacylglycerols and hepatic encephalopathy. Gut. 15:1974;180.
122. Plauth M., Merli M., Kondrup J. Management of hepatic encephalopathy [letter]. N Engl J Med. 337:1997;1921.
123. Nachbauer C.A., Fischer J.E. Nutritional support in hepatic failure. Fischer J.E., Surgical nutrition. 1st ed. 1983;551 Little, Brown, Boston.
124. McClain C.J., Marsano L., Burk R.F., Bacon B. Trace metals in liver disease. Semin Liver Dis. 11:1991;321.
125. Watanabe F.D., Kahaku E.A., Demetriou A.A. Enteral nutrition and liver failure. Rombeau J.L., Rolandelli R.H., Enteral and tube feeding. 1997;417 WB Saunders, Philadelphia.
126. Leevy C.M., Thompson A., Baker H. Vitamins and liver injury. Am J Clin Nutr. 23:1970;493.
127. Reding P., Duchateau J., Bataille C. Oral zinc supplementation improves hepatic encephalopathy. Lancet. 2:1984;493.
128. Van Der Rijt C.C.D., Schalm S.W., Schat H., Foeken K., DeJong G. Overt hepatic encephalopathy precipitated by zinc deficiency. Gastroenterology. 100:1991;1114.
129. Bresci G., Parisi G., Banti S. Management of hepatic encephalopathy with oral zinc supplementation a long-term treatment . Eur J Med. 2:1993;414.
130. Riggio O., Ariosto F., Merli M., et al. Short-term oral zinc supplementation does not improve chronic hepatic encephalopathy. Results of a double-blind crossover trial. Dig Dis Sci. 36:1991;1204.
131. Thuluvath P.J., Triger D.R. Selenium in chronic liver disease. J Hepatol. 14:1992;176.
132. Chase R.A., Davies M., Trewby P.N., Silk D.B.A., Williams R. Plasma amino acid levels in patients with fulminant hepatic failure treated with polyacrylonitrile haemodialysis. Gastroenterology. 75:1978;1033.
133. Fryden A., Weiland O., Martensson J. Successful treatment of hepatic coma probably caused by acute infectious hepatitis with balanced solution of amino acids. Scand J Infect Dis. 14:1982;177.
134. Forbes A., Wicks C. Fulminant hepatic failure nutrition and fat clearance. Recent Adv Nutr. 1:1990;67A.