Nutritional Support in Patients with Severe Acute Pancreatitis-Current Standards

Jabłońska, Beata; Mrowiec, Sławomir

doi:10.3390/nu13051498

Cited by 44 publications

(50 citation statements)

References 86 publications

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“…For the route of EN delivery, several randomised controlled trials had shown that there was no difference in terms of mortality, infectious complications, length of hospital stay, or energy balance between nasogastric (NG) and nasojejunal (NJ) feeding in patients with severe acute pancreatitis (SAP) requiring tube feeding [ 1 – 4 ]. Given the technical difficulty for NJ tube insertion, NG feeding has been recommended as the primary choice for SAP patients [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors of nasogastric feeding intolerance in moderately-severe to severe acute pancreatitis

Lin

Cheng

et al. 2022

BMC Gastroenterol

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Background The importance of enteral nutrition (EN) in acute pancreatitis (AP) has been emphasised. Nasogastric (NG) feeding has been the preferred route for EN delivery in most AP patients intolerant to oral intake. However, gastric feeding intolerance (GFI) was frequently reported, especially in patients with more severe diseases. This study aimed to investigate the incidence and risk factors for GFI in moderately-severe to severe AP. Methods This is a single-centre, retrospective study. All the data were extracted from an electronic database from April 2020 to May 2021. Data were prospectively collected during hospitalisation. Patients diagnosed with moderately-severe to severe AP and admitted within seven days from the onset of abdominal pain were assessed for eligibility. Patients who showed signs of intolerance to gastric feeding and required switching to nasojejunal (NJ) feeding were deemed GFI. Multivariable logistic regression was performed to assess potential risk factors of GFI. Results A total of 93 patients were analysed, of whom 24 were deemed GFI (25.8%), and the rest tolerated NG feeding well (n = 69). In patients with GFI, the median time of switching to NJ feeding was five days (interquartile range: 4–7 days) after admission. The multivariable analysis showed that respiratory failure (odds ratio = 3.135, 95% CI: 1.111–8.848, P = 0.031) was an independent risk factor for GFI.The mean daily energy delivery in the following three days after switching to NJ feeding was significantly higher than the first three days after initiation of NG feeding in patients with GFI [920.83 (493.33–1326) vs. 465 (252.25–556.67) kcal, P < 0.001]. Conclusion GFI is common in moderately-severe to severe AP patients with an incidence of 25.8%, and the presence of respiratory failure may increase the risk of GFI.

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Section: Introductionmentioning

confidence: 99%

Incidence and risk factors of nasogastric feeding intolerance in moderately-severe to severe acute pancreatitis

Lin

Cheng

et al. 2022

BMC Gastroenterol

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“…Severe acute pancreatitis is a critical illness in pancreatitis characterized by sudden onset and critical conditions. Inappropriate treatment aggravates the condition and is accountable for over 25% acute pancreatitis-associated mortality [ 1 , 2 ]. Clinically, surgery is the mainstay, yet strong evidence suggest that surgical treatment is associated with multiple complications, postoperative body pain, and slow postoperative recovery [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Somatostatin plus Ulinastatin in the Treatment of Severe Acute Pancreatitis and Its Effect on Serum Cytokine Levels

Yang

Zhao

2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To investigate the effect of somatostatin combined with ulinastatin in the treatment of patients with severe acute pancreatitis and its effect on serum cytokine levels. Methods. This study is a retrospective trial. One hundred patients with severe acute pancreatitis in our hospital between March 2020 and May 2021 were recruited and assigned into the control group (ulinastatin alone) and experimental group (somatostatin plus ulinastatin) according to different treatment methods, 50 cases each. The clinical efficacy and serum cytokine levels of the two groups were compared. Results. Somatostatin plus ulinastatin was associated with a higher total effective rate versus ulinastatin alone ( p < 0.05 ). After treatment, the experimental group observed significantly better interleukin-10 (IL-10), interleukin-18 (IL-18), and tumor necrosis factor-α (TNF-α) when compared with those in the control group ( p < 0.05 ); somatostatin plus ulinastatin resulted in better serum amylase, blood calcium, blood urea nitrogen, blood sugar, and white blood cell count versus ulinastatin alone ( p < 0.05 ). Conclusion. Somatostatin plus ulinastatin is a viable alternative in the treatment of patients with severe acute pancreatitis, with a remarkable efficacy profile. It is worthy of clinical application.

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“…Також існує багато досліджень, присвячених часу початку введення харчових сумішей у пацієнтів з тяжким перебігом ГП. Так, згідно сучасних поглядів, зондове харчування слід починати якомога раніше (24-48 годин від моменту госпіталізації) порівняно з парентеральним харчуванням [2]. Ранній початок ентерального харчування (до 48 годин від моменту госпіталізації) у хворих при тяжкому перебігу ГП асоціюється зі зниженням частоти інфекційних ускладнень на 24 % та смертності на 32 % порівняно з хворими, де ентеральне харчування почалось пізніше [3].…”

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Evaluation of the Efficiency of Nasogastral Nutrition in Patients With Severe Acute Pancreatitis

Kolosovych¹,

Hanol²

2022

Med. Sci. of Ukr.

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Relevance. Early onset of enteral nutrition (up to 48 hours after hospitalization) in patients with severe acute pancreatitis is associated with a 24% reduction in infectious complications and a 32% reduction in mortality. Data on the possibility of nasogastric tube feeding remain contradictory. Objective: comparison of the effectiveness and safety of nasogastric administration of food mixtures in patients with severe acute pancreatitis. Methods. The study included 103 patients with severe acute pancreatitis, which were divided depending on the characteristics of the chosen treatment tactics into three groups: based group (nasogastric nutrition was performed) - 34 patients, comparison group #1 (standard enteral nutrition) - 33 patients and comparison group #2 (parenteral nutrition) - 36 patients. To analyze the effectiveness of nutritional support in the study groups after 7 and 14 days from the beginning of treatment, the level of laboratory parameters was assessed, the incidence of local complications, mortality, duration of multiorgan failure and hospital stay were analyzed. Results. After 7 and 14 days of nutritional support, a significant difference was found between total protein, albumin, creatinine, urea, cholesterol, glucose and serum Na + (p<0.05) between patients in the main group and comparison group #2, with the level of cholesterol, K + and Na + corresponded to the norm in both groups. There was also a significant difference in the incidence of infected local complications of severe acute pancreatitis in the main group and comparison group #2 - 35.3% and 61.1%, respectively (χ2=4.59, 95% CI 2.43-45.53, p=0.03), duration of multiorgan failure - 12.2±1.7 [8-16] days and 15.3±1.1 [13-18] days, respectively (p<0.001), duration of hospital stay - 55.5±30.5 [27-124] days and 71.5±35.9 [35-148] days, respectively (p=0.04) and fatalities - 14.7% and 36.1%, respectively (χ2=4.13, 95 % CI 0.81-39.68, p=0.04). When comparing these indicators between the main group and the comparison group #1 no significant difference was obtained (p>0.05). Conclusions. Nasogastric nutrition is an effective and safe method of administration of mixtures in patients with severe acute pancreatitis and can be considered as an alternative to enteral nutrition.

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Nutritional Support in Patients with Severe Acute Pancreatitis-Current Standards

Cited by 44 publications

References 86 publications

Incidence and risk factors of nasogastric feeding intolerance in moderately-severe to severe acute pancreatitis

Incidence and risk factors of nasogastric feeding intolerance in moderately-severe to severe acute pancreatitis

Somatostatin plus Ulinastatin in the Treatment of Severe Acute Pancreatitis and Its Effect on Serum Cytokine Levels

Evaluation of the Efficiency of Nasogastral Nutrition in Patients With Severe Acute Pancreatitis

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