Liver and Nutrition Flashcards
Location of the Liver
RUQ
Bellow the diaphragm
Abdominal cavity
Number of Lobes (Liver)
2
Liver Blood Supply
Hepatic Artery (oxygenated blood) Portal Vein (venous, nutrient rich blood)
Key Liver Functions
Storage (glycogen, iron)
Metabolism (carbohydrate, fats, etc)
Filtration (bacteria, antigens, “worn” blood cells)
Detoxification (ETOH, drugs, circulating hormones)
AST
Enzyme released from hepatocyte during injury
Recent/Acute Injury
Not Liver Specific
ALT
Enzyme released from hepatocyte during injury
Recent/Acute injury
Liver Specific
Albumin
Major protein manufactured by the liver
Chronic liver injury (influenced by nutritional status)
1/2 life of 20 days. Make take a while to have appreciable differences in serum albumin
Prothrombin Time (PT)
Influenced by the livers ability of disability to manufacture clotting factors.
Sensitive and acute
*not reliable if on warfarin
Alk Phos
Low specificity for liver function
Increased in obstruction of bile flow, pregnancy and bone disease
GGT
Enzyme
Increased in obstruction to bile flow (cholestasis)
Also increased in ETOH use/abuse
Preferred route of feeding in the ICU
enteral
Reason why enteral feeding is preferred vs TPN
low cost
gut integrity
lower incidence of infection
What is TPN
Total Parenteral Nutrition
When do we use TPN
Non - functional GI tract (surgery)
a supplement to enteral feeding
Refeeding Syndrome
Rapid movement of various electrolytes (K, Mg, Ca, PO4) into the the cell following the initiation of feeding and the release of insulin.
Hypophosphatemia is the hallmark
