Clin Nutr Res.  2017 Apr;6(2):136-144. 10.7762/cnr.2017.6.2.136.

A Case Report of the Nutrition Support for a Patient with HELLP Syndrome

• Yeon SE
• Kim SJ
• Kim JH
• Chung HY
• Na SH
• Lee SM

• KMID: 2383702
• DOI: http://doi.org/10.7762/cnr.2017.6.2.136

Abstract

A 30-year-old female patient, 18 weeks gestational age, with no prior medical history was admitted to hospital complaining severe right upper quadrant pain. The patient was admitted to intensive care unit (ICU) after emergency surgery to treat intraperitoneal hemorrhage caused by rupture of liver hematoma. Despite the absence of high blood pressure, the patient was diagnosed with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome on the basis of abnormal levels of blood aspartate aminotransferase/alanine aminotransferase, lactate dehydrogenase, total bilirubin, direct bilirubin, C-reactive protein (CRP) and platelet along with liver damage and proteinuria. While in ICU, the patient was given total parenteral nutrition (TPN) and enteral nutrition (EN) for -20 days because oral feeding was impractical. In the early stage, TPN supply was not sufficient to meet the elevated nutritional demand induced by disease and surgery. Nevertheless, continuous care of nutrition support team enabled satisfactory EN and, subsequently, oral feeding which led to improvement in patient outcome.

Keyword

HELLP syndrome; Nutrition support; Enteral nutrition; Parenteral nutrition

MeSH Terms

Adult
Aspartic Acid
Bilirubin
Blood Platelets
C-Reactive Protein
Emergencies
Enteral Nutrition
Female
Gestational Age
HELLP Syndrome*
Hematoma
Hemolysis
Hemorrhage
Humans
Hypertension
Intensive Care Units
L-Lactate Dehydrogenase
Liver
Parenteral Nutrition
Parenteral Nutrition, Total
Platelet Count
Pregnancy
Proteinuria
Rupture
Aspartic Acid
Bilirubin
C-Reactive Protein
L-Lactate Dehydrogenase

Figure

• 

  Figure 1 Progression of nutritional support and clinical aspects of the patient. HOD, hospital onset of day; NST consult, nutrition support team consult; NSVD, normal spontaneous vaginal delivery; TPN, total parenteral nutrition.

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  Figure 2 The amount of energy delivery during hospital stays. HOD, hospital onset of day.

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  Figure 3 The amount of protein delivery during hospital stays. HOD, hospital onset of day.

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  Figure 4 Changes in the cholesterol, albumin, and serum CRP concentration of the patient. CRP, C-reactive protein.

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