Early oral refeeding based on hunger in moderate and severe acute pancreatitis: A prospective controlled, randomized clinical trial

Abstract

This controlled, randomized clinical trial confirmed the effectiveness and feasibility of EORF based on hunger in patients with moderate or severe AP. EORF could shorten the length of hospitalization in patients with moderate or severe AP.

Acute Pancreatitis, Actualization and Evidence Based Management

“…Parenteral immunonutrition signifi cantly reduced the risk of infectious complications (RR ¼ 0.59; 95% CI, 0.39-0.88; p= 0.05) and mortality (RR ¼ 0.26; 95% CI, 0.11-0.59; p= 0.001). Length of hospital stay was also shorter in patients who received immunonutrition (MD ¼ 2.93 days; 95% CI, 4.70 to 1.15; p=0.001), but this results seem to be of low to very low quality [52,53].…”

“Re. ‘Early oral refeeding based on hunger in moderate and severe acute pancreatitis: A prospective controlled, randomized clinical trial.’ Can we really do without enteral nutrition?” Author's response

“…In responding to some of the questions raised by Dr. Dupont's letter concerning our study [1,9] it should be noted that our study took place between 2011 and 2012, before the recently published IAP/APA guidelines (2013) [5] and Revised Atlanta classification (2012) [10]. Severity of AP in our original design study was assessed using the Atlanta classification (1992); therefore, some of the cases designated as severe AP needed to be recategorized as moderate, in accordance with the Revised Atlanta classification [11].…”

“…Fasting is common in the initial stages of severe AP, and EORF is important for early recovery and discharge for severe AP. Thus, the aim of our study was to determine the feasibility and safety of EORF based on hunger in patients with severe AP [9].…”

Clinical update on fluid therapy and nutritional support in acute pancreatitis

“…A low fat diet appears as safe as clear liquids [43]. In SAP, oral feeding may begin with onset of hunger (typically after a mean 8 days [44]), which may shorten hospital LOS [44]. EN is recommended due to a lower risk of infectious complications compared to PN [41,42,45].…”