engleski

Effects of enteral nutrition in moderate to severe acute pancreatitis

Introduction: Nutritional support as enteral preparations is thought to have positive effects on outcome of acute pancreatitis. However, only few trials performed on rather small number of patients showed no statistically significant effects on complications and mortality. Objectives: To determine beneficial and harmful effects of enteral nutrition administered via a nasojejunal tube in comparison to intravenous fluid replacement without nutritional support in patients with moderate to severe acute pancreatitis. Patients and Methods: Hundred-eleven consecutive patients with acute pancreatitis and APACHE II score ³6 were randomized into one of two groups, enteral nutrition group (group I) and group with no nutritional support (group II). There were no significant differences in age, gender, BMI, etiology and disease severity between groups. 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 to 10 after admission and graded according to CTSI classification. Results: Fifty patients were randomized in group I and sixtyone patients in group II. There were no significant differences in local (p = 0, 245) and systemic (p = 0, 305)complications according to Atlanta criteria between the two groups. No significant difference in ICU admission (p = 0, 111) and mortality (p = 0, 743) was found either. Conclusion: Our results could not confirm that nutritional support has beneficial or harmful effects on the outcome of acute pancreatitis.

Enteral nutrition; acute pancreatitis; complications; mortality

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