Semi‐Elemental Formula or Polymeric Formula: Is There a Better Choice for Enteral Nutrition in Acute Pancreatitis? Randomized Comparative Study

Tiengou, Laurent-Eric; Gloro, Romain; Pouzoulet, J.; Bouhier, Karine; Read, Marie-Hélène; Arnaud-Battandier, F; Plaze, Jean-Marie; Blaizot, Xavier; Dao, Thông; Piquet, Marie-Astrid

doi:10.1177/014860710603000101

Cited by 119 publications

(79 citation statements)

References 21 publications

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“…De maneira simples, as fórmulas podem ser divididas em três categorias: elementares ou semielementares, contendo aminoácidos ou oligopeptídeos, maltodextrinas e triglicérides de cadeias médias e longas; poliméricas, contendo proteínas não hidrolisadas, maltodextrinas e oligofrutossacarídeos, além de triglicérides de cadeias longas; e as dietas imunomoduladoras, contendo substratos que supostamente modulam a atividade do sistema imune, como probióticos, glutamina, arginina e ácidos graxos ômega-3 82 . Em casos de PA, o uso de fórmulas elementares apresenta uma série de vantagens teóricas quando comparadas às poliméricas e, de acordo com as mesmas, parecem ser mais vantajosas e superiores às poliméricas na terapia nutricional inicial da PA, como melhor absorção intestinal, menor estímulo para a secreção exócrina pancreática e melhor tolerância; entretanto, o preço significativamente maior desse tipo de fórmulas elementares e a reduzida disponibilidade constituem uma barreira para seu amplo uso.…”

Section: Aspectos Nutricionaisunclassified

Acute pancreatitis in pediatrics: a systematic review of the literature

2012

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Objective: To describe the main epidemiological, clinical, diagnostic and treatment aspects of children with acute pancreatitis.Sources: Systematic review of MEDLINE and SciELO databases in the last 5 years on acute pancreatitis in children, as well as consultation of relevant references on the texts obtained. Summary of the findings:Cases of acute pancreatitis in children have received growing attention in recent years, and an increase in the number of cases has been reported in several studies. The main etiologies in children involve biliary disease, drug-induced pancreatitis, recurrent hereditary pancreatitis and trauma, and up to 30% of cases have no defined etiology. The diagnosis is based on the combination of clinical and laboratory aspects with the increase of acinar enzymes and radiologic tests. Initial support treatment, with proper volume replacement and correction of the metabolic disturbances, besides specific nutritional therapy, are the fundamental points in the handling of acute conditions. Long term complications are unusual, and mortality rates are inferior to the rates for the adult population. Conclusions:The early diagnosis and the appropriate handling can contribute to a better outcome for the child with pancreatitis and to prevent the immediate and late complications related to the disease. More studies are required to better explain aspects related to the clinical and radiological diagnosis of pancreatitis in children, as well as aspects related to the nutritional therapy for this age group. J Pediatr (Rio J). 2012;88(2):101-14: Pancreatitis, pediatrics, nutritional support, morbidity, enteral nutrition. ResumoObjetivo: Descrever os principais aspectos epidemiológicos, clínicos, diagnósticos e do tratamento de crianças com pancreatite aguda. Fontes dos dados:Realizada revisão sistemática das bases de dados MEDLINE e SciELO nos últimos 5 anos sobre pancreatite aguda em crianças, bem como consultadas referências relevantes dos textos obtidos. Síntese dos dados:Os casos de pancreatite aguda em crianças recebem crescente atenção nos últimos anos, sendo verificado um aumento na incidência da doença em diversos estudos. As principais etiologias em crianças envolvem doença biliar, pancreatite secundária a medicamentos, pancreatite hereditária recorrente e trauma, sendo até 30% dos casos sem etiologia definida. O diagnóstico baseia-se na combinação de aspectos clínicos, laboratoriais com elevação das enzimas acinares e testes radiológicos. Tratamento de suporte inicial, com reposição volêmica adequada e correção dos distúrbios metabólicos, além de terapêutica nutricional específica, são os pontos fundamentais no manejo dos quadros agudos. Complicações a longo prazo são incomuns, e as taxas de mortalidade, inferiores às da população adulta. Conclusões:O diagnóstico precoce e o manejo apropriado podem contribuir para a melhor evolução da criança com pancreatite e prevenir as complicações imediatas e tardias relacionadas à doença. Mais estudos são necessários para melhor elucidar aspectos re...

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Section: Aspectos Nutricionaisunclassified

Acute pancreatitis in pediatrics: a systematic review of the literature

2012

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“…Studies of 100% WHP and pancreatitis are characterized in Table 2 [ 6,9,[27][28][29][30][31][32] . In a prospective pilot study conducted by Tiengou et al [27] , patients with severe acute pancreatitis who required nasojejunal nutrition were randomized to receive a 100% WHP semi-elemental diet (n = 15) or a standard polymeric formula (n = 15) for seven days.…”

Section: Pancreatitismentioning

confidence: 99%

“…In a prospective pilot study conducted by Tiengou et al [27] , patients with severe acute pancreatitis who required nasojejunal nutrition were randomized to receive a 100% WHP semi-elemental diet (n = 15) or a standard polymeric formula (n = 15) for seven days. Both formulas were well tolerated in patients with acute pancreatitis, though the group on semi-elemental 100% WHP formula provided a more favorable clinical course because it was associated with less weight loss (P = 0.001), a significantly shorter hospital duration (P = 0.006), and a trend towards …”

Section: Pancreatitismentioning

confidence: 99%

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Nutritional and health benefits of semi-elemental diets: A comprehensive summary of the literature

Alexander¹,

Bylsma²,

Elkayam³

et al. 2016

WJGPT

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AIM:To critically review and summarize the literature on nutritional and health outcomes of semi-elemental formulations on various nutritionally vulnerable patient populations who are unable to achieve adequate nutrition from standard oral diets. METHODS:We conducted a comprehensive literature search of Pubmed and Embase databases. We manually screened articles that examined nutritional and health outcomes (e.g. , growth, disease activity, gastrointestinal impairment, mortality, and economic impact) among various patient groups receiving semi-elemental diets. This review focused on full-text articles of randomized controlled clinical trials and other intervention studies, but pertinent abstracts and case studies were also included. Results pertaining primarily to tolerance, digestion, and absorption were summarized for each patient population in this systematic review.

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“…The recommendation of the European Society Parenteral Enteral Nutrition (ESPEN) is that peptide formulas can be used safely (grade A), although polymers formulas can be used if they will be tolerated (grade C) [11]. Tiengou et al published an essay in 2006 that associated the decrease in hospitalization time with the use of peptide formulas for nutritional support with EN, but the trial included only nineteen patients (there were thirty in total, but eleven had a mild to moderate evolution) [31]. Only one meta-analysis has been found in which the objective was to compare the safety and tolerance of EN formulas in severe AP.…”

Section: Severe Apmentioning

confidence: 99%

Nutrition in acute pancreatitis: a review

Frutos

Herranz-Antolín

2014

Open Medicine

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AbstractWe perform an update about nutritional measures that have been adopted in patients with acute pancreatitis (AP). The nutritional support is an essential part of treatment in AP. When the AP is mild or moderate, there is no doubt that is not necessary to use an artificial nutritional support, and it is recommended that oral nutritional support should begin as soon as possible. If the AP is severe, the best way to provide nutritional support is through enteral nutritional (EN) because it reduces infection, length of hospitalization and mortality rate. Parenteral nutrition (PN) should be used only when EN is Impossible. However, there is no scientific evidence for recommending the most optimal route necessary to administer this type of nutritional support; we seek to uncover whether this is by gastric or jejunal route and the proper formula to use. There is an international agreement that the nutritional support should begin quickly, within the first 24 and 72 hours of hospitalization. As conclusion, more research needs to be done concerning nutritional support in AP, and many questions are not been answered yet.

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Semi‐Elemental Formula or Polymeric Formula: Is There a Better Choice for Enteral Nutrition in Acute Pancreatitis? Randomized Comparative Study

Cited by 119 publications

References 21 publications

Acute pancreatitis in pediatrics: a systematic review of the literature

Acute pancreatitis in pediatrics: a systematic review of the literature

Nutritional and health benefits of semi-elemental diets: A comprehensive summary of the literature

Nutrition in acute pancreatitis: a review

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