Indirect Calorimeter Based Study in Patients With Liver Cirrhosis (METALIC)
Liver Cirrhoses
About this trial
This is an interventional treatment trial for Liver Cirrhoses focused on measuring Indirect calorimeter, Resting energy expenditure, substrate utilization, nitrogen balance
Eligibility Criteria
Inclusion Criteria:
Disease groups:
• Patients with liver cirrhosis (diagnosis established based on routine clinical, biochemical and at least radiological, endoscopic or histological parameters.) admitted in Liver coma Intensive care unit and those admitted in ward.
Disease controls:
- Patients with Acute liver failure (diagnosis established based on routine clinical, biochemical and at least radiological parameters) admitted in Liver coma Intensive care unit
- Patients with severe acute pancreatitis (diagnosis established based on routine clinical, biochemical and at least radiological parameters) admitted in Liver coma Intensive care unit
Healthy Controls:
- Healthy subjects- Relatives of patients with no known chronic diseases (Chronic obstructive pulmonary disease, Coronary artery disease, Type 2 diabetes, Hypertension, Hypothyroidism, Koch's disease) or not on any long term medications.
- Patients with liver cirrhosis (diagnosis established based on routine clinical, biochemical and at least radiological, endoscopic or histological parameters.) admitted in Liver coma Intensive care unit who require mechanical ventilation
Exclusion Criteria:
- Age<18 years
- Active upper gastrointestinal bleeding
- If there are conditions which precluded IC, such as an FiO2 >60 %, failure to cooperate, agitation, seizure activity, spasticity, or positive end-expiratory pressure (PEEP) >10 mmHg.
- Pregnant women
- Refused to consent/ inability to obtain informed consent.
- Known long standing diabetic
- If there is any evidence of medical/surgical instability
- Hepatocellular carcinoma Extrahepatic malignancies
- With persistent gastrointestinal dysfunction and ileus
- Patients who would be readmitted to the ICU
- Known long standing diabetic
- Terminally ill patients on high inotropic support
- Acute liver failure
- If there is any evidence of medical/surgical instability
- If patients are taking any portion of nutrition by mouth.
- Pregnant women
- Refused to consent/ inability to obtain informed consent.
- Patient on CRRT- continuous renal replacement therapy
- Severe co morbidities such as Chronic kidney disease requiring maintenance dialysis, COPD and Cardiac pathologies (Acute myocardial infarction, heart failure, ).
- Hepatocellular carcinoma Extrahepatic malignancies
- Moribund patient with likely survival <24 hours
- Patients enrolled in other drug trials.
Sites / Locations
- ILBS
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Control arm
Intervention arm
This is the group of critically ill cirrhotic patients on mechanical ventilator support who would receive the nutritional therapy as per the standard enteral nutritional practice in a critical care setting in cirrhotics till the period admitted in ICU(Intensive care unit) 35-40 Kcal/Kg IBW/day; 1.5g protein per kg per day.
This is the group of critically ill cirrhotic patients on mechanical ventilator support who would receive the nutritional therapy based on indirect calorimetry measurements till the period admitted in ICU(Intensive care unit); 1.5g protein per kg per day.