Early nasojejunal tube feeding versus nil-by-mouth in acute pancreatitis: A randomized clinical trial

Stimac, Davor; Poropat, Goran; Hauser, Goran; Licul, Vanja; Franjić, Neven; Zujić, Petra Valković; Milić, Sandra

doi:10.1016/j.pan.2016.04.003

Cited by 52 publications

(52 citation statements)

References 31 publications

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“…Importantly, in the control group, 69% of patients did not require a nasoenteral tube, thus avoiding potential patient discomfort 52. A second recent RCT, comparing early nasojejunal feeding (<24 hour) with no nutritional support in 214 patients, also failed to show benefits from early nutritional support 53. Based on these RCTs, tube feeding in predicted severe pancreatitis can be limited to those patients who have insufficient oral caloric intake after 3–5 days.…”

Section: Early Phase Of Acute Pancreatitismentioning

confidence: 99%

Acute pancreatitis: recent advances through randomised trials

Dijk¹,

Hallensleben

Santvoort³

et al. 2017

Gut

345

225

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Acute pancreatitis is one of the most common GI conditions requiring acute hospitalisation and has a rising incidence. In recent years, important insights on the management of acute pancreatitis have been obtained through numerous randomised controlled trials. Based on this evidence, the treatment of acute pancreatitis has gradually developed towards a tailored, multidisciplinary effort, with distinctive roles for gastroenterologists, radiologists and surgeons. This review summarises how to diagnose, classify and manage patients with acute pancreatitis, emphasising the evidence obtained through randomised controlled trials.

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Section: Early Phase Of Acute Pancreatitismentioning

confidence: 99%

Acute pancreatitis: recent advances through randomised trials

Dijk¹,

Hallensleben

Santvoort³

et al. 2017

Gut

345

225

View full text Add to dashboard Cite

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“…A randomized controlled trial comparing nasogastric to nasojejunal feeds is currently under study [ 23 ]. A new randomized controlled trial comparing enteral nutrition to nil per mouth in patients hospitalized for AP showed that early enteral nutrition had no significant reduction in persistent organ failure or mortality when compared to the no nutritional support group [ 24 ]. However, in this trial, patients with local or systemic complications were classified as a subgroup and not included in the severe acute pancreatitis group (SAP) according to the Revised Atlanta classification.…”

Section: Necrotizing Pancreatitis: Management and Treatmentmentioning

confidence: 99%

Necrotizing Pancreatitis: Current Management and Therapies

2017

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Acute necrotizing pancreatitis accounts for 10% of acute pancreatitis (AP) cases and is associated with a higher mortality and morbidity. Necrosis within the first 4 weeks of disease onset is defined as an acute necrotic collection (ANC), while walled off pancreatic necrosis (WOPN) develops after 4 weeks of disease onset. An infected or symptomatic WOPN requires drainage. The management of pancreatic necrosis has shifted away from open necrosectomy, as it is associated with a high morbidity, to less invasive techniques. In this review, we summarize the current management and therapies for acute necrotizing pancreatitis.

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“…7 EN preserves gut barrier integrity and function, reducing colonic bacterial overgrowth and diminishing endotoxin and bacterial translocation. 7,38,39 EN over PN showed decreased levels of TNF, IL-1, IL-6, and IL-8 in the EN group. 38 The 2016 American Society for Parenteral and Enteral Nutrition/society of critical care medicine guidelines recommend EN over PN and show a reduction in infectious morbidity (42.6% vs 16.1%, P < .0001) and mortality (16.4% vs 6.1%, P = .02).…”

Section: Oral Nutritionmentioning

confidence: 88%

Acute Pancreatitis: Exploring Nutrition Implications

Murphy

Codner

2020

Nut in Clin Prac

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Diseases of the pancreas vary by type, etiology, pathophysiology, and outcomes. One of the principle therapeutic considerations in all types of pancreatic diseases is nutrition. This review will consider acute pancreatitis (AP). Choice of patient, type and composition of nutrition, and timing of initiation will be discussed as components for achieving the maximum benefits of nutrition therapy in AP. The paradigm of nutrition therapy in AP has shifted to early enteral and/or oral nutrition based on disease severity to help mitigate the underlying inflammatory cascade of events leading to AP, beginning with anatomic and functional intestinal changes. Additionally, newer research investigating the inflammatory changes that instigate, maintain, and propagate AP will be discussed in terms of the nutrition effects on systemic inflammation. Nutrition therapy can mitigate the inflammatory changes in the intestinal tract and help with intestinal motility, bacterial overgrowth and translocation. It can help maintain intestinal bacterial composition and abundance similar to predisease levels. This review will also discuss the changes in the intestinal microbiome and effects of probiotics in AP.

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Early nasojejunal tube feeding versus nil-by-mouth in acute pancreatitis: A randomized clinical trial

Cited by 52 publications

References 31 publications

Acute pancreatitis: recent advances through randomised trials

Acute pancreatitis: recent advances through randomised trials

Necrotizing Pancreatitis: Current Management and Therapies

Acute Pancreatitis: Exploring Nutrition Implications

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