Early Enteral Nutrition and Aggressive Fluid Resuscitation are Associated with Improved Clinical Outcomes in Acute Pancreatitis

Szabó, Flóra K.; Lin, Fang; Cruz, Ligia Alfaro; Abu‐El‐Haija, Maisam

doi:10.1016/j.jpeds.2015.05.030

Cited by 68 publications

(59 citation statements)

References 23 publications

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“…32 Early and aggressive fluid resuscitation in children with normal saline and 5% Dextrose is safe and well-tolerated, but has not been compared to other fluids. 33 The rates of IV fluid in pediatric AP have also not been assessed. One study showed that a combination of early enteral nutrition (< 48 hours) and aggressive fluid management (>1.5-2x maintenance within the first 24 hours) decreased length of stay and complications.…”

Section: Acute Pancreatitismentioning

confidence: 99%

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Pancreatic Disorders

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Fishman

2017

Pediatric Clinics of North America

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Synopsis Once considered uncommon, pancreatic diseases are increasingly recognized in the pediatric age group. Acute, acute recurrent and chronic pancreatitis occur in children with an incidence approaching that of adults. The risk factors in the pediatric age group are broad, prompting the need for a completely different diagnostic and therapeutic approach in children. Although cystic fibrosis is still the most common cause of exocrine pancreatic insufficiency, other causes such as chronic pancreatitis may be as common as Shwachman Diamond syndrome. Long-term effects of pancreatic diseases may be staggering as children suffer from significant disease burden, high economic cost, nutritional deficiencies, pancreatogenic diabetes and potentially pancreatic cancer.

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Section: Acute Pancreatitismentioning

confidence: 99%

“…One study showed that a combination of early enteral nutrition (< 48 hours) and aggressive fluid management (>1.5-2x maintenance within the first 24 hours) decreased length of stay and complications. 33 …”

Section: Acute Pancreatitismentioning

confidence: 99%

Pancreatic Disorders

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Fishman

2017

Pediatric Clinics of North America

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“…In children, aggressive fluid hydration has been defined as a rate of more than 1.5-2 times the maintenance rate of IV fluids, and that was associated with improved outcomes with fewer ICU admissions due to SIRS, and shortened hospital stays 74 . From multiple adult studies it can be concluded that aggressive resuscitation is associated with improved outcomes in AP, but overresuscitation should be avoided.…”

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confidence: 99%

EPC/HPSG evidence-based guidelines for the management of pediatric pancreatitis

et al. 2018

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“…There are limited studies that characterize the hospital course, inpatient procedures, clinical outcomes, mortality, and disease burden in children with acute pancreatitis. 8–10 Current published studies lack information about the national health care use for children with acute pancreatitis, because most studies are single center and retrospective in nature. 7 …”

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Acute Pancreatitis Admission Trends: A National Estimate through the Kids' Inpatient Database

Abu‐El‐Haija

El-Dika

Hinton

et al. 2018

The Journal of Pediatrics

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Objectives To evaluate national health care use and costs for pediatric acute pancreatitis. Study design The Kids’ Inpatient Database for 2006, 2009, and 2012 was queried for patients with a principal diagnosis of acute pancreatitis. Cases were grouped by age: preschool (<5 years of age), school age (5–14 years of age), and adolescents (>14 years of age). Results A total of 27 983 discharges for acute pancreatitis were found. The number of admissions increased with age: young n = 1279, middle n = 8012, and older n = 18 692. Duration of stay was highest in preschool children (median, 3.47 days; IQR, 2.01–7.35), compared with school age (median, 3.22 days; IQR, 1.81–5.63) and adolescents (median, 2.87 days; IQR, 1.61–4.81; P < .001). The median cost of hospitalization varied with age: $6726 for preschoolers, $5400 for school-aged children, and $5889 for adolescents (P < .001). Acute pancreatitis–associated diagnoses varied by age. The presence of gallstone pancreatitis, alcohol, and hypertriglyceridemia was more common among older children compared with younger children (P < .001). There was an increasing trend in acute pancreatitis, chronic pancreatitis, and obesity for the 2 older age groups (P < .001). Conclusion Admission of children for acute pancreatitis constitutes a significant healthcare burden, with a rising number of admissions with age. However, the cost and duration of stay per admission are highest in young children.

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Early Enteral Nutrition and Aggressive Fluid Resuscitation are Associated with Improved Clinical Outcomes in Acute Pancreatitis

Cited by 68 publications

References 23 publications

Pancreatic Disorders

Pancreatic Disorders

EPC/HPSG evidence-based guidelines for the management of pediatric pancreatitis

Acute Pancreatitis Admission Trends: A National Estimate through the Kids' Inpatient Database

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