Feed Me!: Early Enteral Nutrition in Acute Pancreatitis
Fri, 11/18/2016 - 6:45am
Editor:
- 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:
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Full text available at: http://www.ncbi.nlm.nih.gov/pubmed/20091534