Feed Me!: Early Enteral Nutrition in Acute Pancreatitis

Fri, 11/18/2016 - 6:45am
Author: 
Kara Huston, MD
Editor: 
Haney Mallemat, MD

  • Background: Historically the belief was that the pancreas needed to rest during this time of acute stress. Patients were made NPO and given parenteral nutrition until the pancreas recovered.
  • As it turns out this makes both the patient and the pancreas unhappy.
  • Evidence to Feed: A Cochrane Review in 2010 compared enteral nutrition (EN) versus total parenteral nutrition (TPN) for acute pancreatitis:
  • Eight randomized clinical trials were reviewed
  • A total of 348 patients were included
  • Mean length of hospital stay was reduced by 2.37 days in the EN vs. TPN groups

 

RR

95% CI

Death

0.50

0.28-0.91

Multi-organ Failure (MOF)

0.55

0.37-0.81

Systemic Infection

0.39

0.23-0.65

Operative Interventions

0.44

0.29-0.67

Local Septic Complications

0.74

0.40-1.35

Other Local Complications

0.70

0.43-1.13

Death in Severe Pancreatitis

0.18

0.06-0.58

MOF in Severe Pancreatitis

0.46

0.16-1.29

  • Summary: Early enteral feeding in acute pancreatitis is associated with better clinical outcomes, this association was strongest for risk of death in severe pancreatitis.

 References:

  1. Full text available at: http://www.ncbi.nlm.nih.gov/pubmed/20091534