Nutrition & GI Flashcards
Factors not synthesized in liver?
Factor 4: calcium
Factor 8: synthesis in reticule endothelial system
What metabolic derangement seen in cirrhosis?
Met alkalosis with hypoxia
Most specific indicator of liver injury
Alanine aminotransferase (ALA)
The earliest indicator of decreased synthetic function of liver is
Diminishing factor 7 (its half life is 4 hours)
The primary cause of decreased liver blood flow during intra abdominal surgery is. ….
Surgical manipulation
Effect of liver blood flow with the following
Volatiles
Neuraxial
Mechanical vent + PEEP
Maintained
Hypotension-> decreases LBF
Decreased CO -> decreases LBF
PT and INR levels in postop donor hepatectomy
Elevated up to 7 days postop
Ca level except to …. in liver transplantation commonly occur during …. and ….
HypoCa
Dissection and anhepatic phase
Earliest marker of poor nutrition is
Prealbumin
TPN effect on extubation
TPN rich in Carbs -> increases CO2 production-> delays weaning
Common cause of nutrition deficiency causing muscle weakness is
Hypo Po4
Sudden DC of TPN results in
Hypoglycemia
TPN rich component and its complications
Carbs -> delay vent weaning
Amino acids -> hyper Ammonia, met acidosis
Lipid -> cholestasis
Respiratory quotient is …
Ratio of CO2 to the amount of O2 consumption
Ratio of 1 result from pure Carb oxidation
Ratio of 0.7 result from fat oxidation
Goal of TPN prevention of complications is to avoid
1.
2.
And RQ goal should kept between …
- Fatty infiltration of the liver from excessive fat administration
- Respiratory distress from excessive Carb administration
Respiratory quoteient goal during TPN is between 0.7 and 1
