Cirrhosis: An Analysis of Evidence-Based Practice
Characterized by progressive tissue injury and scarring, cirrhosis is among the leading causes of chronic liver failure in the United States. Recent research conducted by the National Institutes of Health indicated that the prevalence of cirrhosis, especially in clients diagnosed with Hepatitis C, has increased steadily throughout the past decade and will likely continue to increase in the future (Kanwal et al., 2011). Caused by recurrent tissue damage and inflammation, cirrhosis occurs as healthy hepatocytes (liver cells) are replaced by fibrotic and non-functional scar tissue through natural healing processes. Although liver tissue is normally very resilient, sustained injury eventually outpaces restorative capacity and a majority of functional tissue is replaced with collagenous tissue and liver failure occurs. In the United States, cirrhosis is most commonly caused by Hepatitis C, alcoholism, fatty liver disease, and biliary obstruction (Kanwal et al., 2011). Due to the increase in prevalence and the seriousness of the condition, cirrhosis represents a significant healthcare issue. The treatment and care of clients diagnosed with cirrhosis is complex. The following information addresses several of the major aspects of nursing care associated with the treatment of clients diagnosed with cirrhosis. Additionally, current studies regarding the treatment of cirrhosis will be evaluated in an effort to assess their readiness to be incorporated into current evidenced-based nursing practice.
Malnutrition, a common complication of advanced hepatic disease including cirrhosis, is associated with poor patient outcomes and diminished quality of life. Although nutrition therapy is accepted practice in the treatment of patients diagnosed with cirrhosis, questions have been raised regarding the effectiveness of nutritional supplements that extend beyond a balanced diet. Noting a lack of existing research supporting the use of nutritional supplements, a recent European study sought to critically evaluate the efficiency of nutritional supplements in the treatment of cirrhosis.
Conducted in northern France from June 2004 to December 2008, the study was designed as a randomized, prospective multi-center trial involving a population of ninety-nine participants (). To be included in the population, individuals had to be eighteen years of age or older, have a medical diagnosis of alcoholic cirrhosis with no history of acute alcoholic...