engleski

Comparison of enteral nutrition and fasting in acute pancreatitis

Introduction: The aim of our trial was to compare the beneficial and harmful effects of enteral nutrition via a nasojejunal tube versus conventional treatment consisting of nil-by-mouth plus intravenous fluids replacement regimen in patients with moderate to severe acute pancreatitis. Aims & Methods: Forty-five consecutive patients with the diagnosis of acute pancreatitis and an APACHE II score  6 were randomized into one of the two groups, the enteral nutrition group (group I) and the conventional therapy group (group II). There were no significant differences in age, gender, BMI and etiology between the groups. The severity of acute pancreatitis was determined by APACHE II and Ranson scoring systems. Patients in group I received daily 105kJ (25kcal)/kg and 1, 5g/kg of proteins, while patients in group II received only fluid replacement with crystalloid solutions. The nasojejunal feeding tube was placed within 24 hours of admission and confirmed radiographically. All cases were assessed by CT between days 5 – 10 after admission and graded according to CTSI classification. Results: Twenty-two patients were randomized in group I and twenty-three patients in group II. There was no significant difference in local (p=0, 586) and systemic (p=0, 232) complications according to Atlanta criteria between the two groups. Two patients in group I and one patient in group II died within five days of admission. Conclusion: In our study we have found that fasting patients do not have inferior outcome than enterally nourished patients with moderate to severe acute pancreatitis.

Acute pancreatitis; nutrition; complications; mortality

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