A randomised clinical trial to assess the effect of total enteral and total parenteral nutritional support on metabolic, inflammatory and oxidative markers in patients with predicted severe acute pancreatitis (APACHEE II ≥ 6)

Gupta, Rajesh; Patel, Krutika; Calder, Philip C.; Yaqoob, Parveen; Primrose, John; Johnson, C. D.

doi:10.1159/000073657

Cited by 210 publications

(182 citation statements)

References 22 publications

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“…A recent randomized trial by Pandey et al (9) compared oral bolus refeeding (started 5 [5][6][7][8][9][10][11][12][13][14][15][16][17][18] days after the onset of acute pancreatitis) and jejunal refeeding (started on 7 [6][7][8][9][10][11][12][13][14][15][16][17] days) and found a lower risk of pain relapse in jejunally refeed patients. Further, a randomized trial by Eatock et al (16) demonstrated no difference in pain and analgesic requirement between early nasogastric and nasojejunal tube feeding administered within 72 h after onset of pain in patients with severe acute pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

Oral Refeeding After Onset of Acute Pancreatitis: A Review of Literature

Petrov¹,

Santvoort²,

Besselink³

et al. 2007

Am J Gastroenterology

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BACKGROUND: Oral refeeding in patients recovering from acute pancreatitis may cause pain relapse. Patients with pain relapse may be ill for prolonged periods, thereby consuming additional health care resources. We aimed to determine the incidence and risk factors of pain relapse on the basis of reviewing all studies on oral refeeding in acute pancreatitis. METHODS:Relevant literature cited in three electronic databases (Cochrane Central Register of Controlled Trials, EMBASE, and MEDLINE) as well as the abstracts of major gastroenterological meetings was reviewed. Outcome measures studied were the incidence of pain relapse and length of hospital stay. RESULTS:A total of three studies met the inclusion criteria. Sixty of 274 patients (21.9%) experienced pain relapse during the course of acute pancreatitis. In 47 of 60 (78.3%) patients pain relapse occurred within 48 h after commencement of oral refeeding. Two studies showed a significantly higher Balthazar's CT score on hospital admission in patients with pain relapse, whereas all three studies found no difference in the severity scores between patients with and without pain relapse. All three studies found a significant increase in the length of hospital stay in patients with pain relapse.CONCLUSIONS: The incidence of pain relapse after oral refeeding in acute pancreatitis is relatively high. Thereby, the quest for new therapeutical modalities that can prevent pain relapse is of current importance.

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Section: Discussionmentioning

confidence: 99%

Oral Refeeding After Onset of Acute Pancreatitis: A Review of Literature

Petrov¹,

Santvoort²,

Besselink³

et al. 2007

Am J Gastroenterology

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“…There have been a number of randomized prospective, but not double-blind, trials that have compared enteral feeding with TPN (92,93,(95)(96)(97). All have included relatively few patients (median 33, range 17-53) that have differed considerably in entry criteria.…”

Section: Level Of Evidence: IImentioning

confidence: 99%

Practice Guidelines in Acute Pancreatitis

Banks

Freeman

2006

Am J Gastroenterology

1,677

980

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“…The traditional treatment of AP are as follows: fasting, somatostatin or analogues to inhibit the activity of pancreatin, prophylaxis antibiotics and sufficient intravenous fluids (3). Nutritional support of SAP is an essential part of the disease management (2,4). Patients with acute pancreatitis are either treated with bowel rest or treated with parenteral nutrition to allow the pancreas to "rest" until the panreatin return to normal (5).…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis: Total Parenteral Nutrition Versus Total Enteral Nutrition in Predicted Severe Acute Pancreatitis

et al. 2012

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Background Total parenteral nutrition (TPN) as a traditional mode of treatment in severe acute pancreatitis was still used widely in clinical work. In addition, enteral nutrition treatment methods have developed; early enteral nutrition has already been highlighted for severe acute pancreatitis, but the therapeutic risks versus benefits need to be studied. Aims and Objective To compare total parenteral nutrition with total enteral nutrition (TEN) in patients with severe acute pancreatitis by performing a meta-analysis. Materials and Methods Electronic databases including PubMed, EMBASE, Science Citation Index, were searched to find relevant randomized controlled trials. Two reviewers independently identified relevant trials evaluating the effect of total parenteral nutrition and early enteral nutrion. Outcome measures were the mortality, hospital length of stay, infectious complications, duration of nutrition, organ failure and surgical inter- p=0.22,)] and as for duration of nutrition [p=0.72, 95%CI -1.50(-9.56-6.56)] there was not enough data to compare the differences. Conclusion Total enteral nutritional support is associated with lower mortality, fewer infectious complications, decreased organ failure and surgical intervention rate compared to parenteral nutritional support.

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A randomised clinical trial to assess the effect of total enteral and total parenteral nutritional support on metabolic, inflammatory and oxidative markers in patients with predicted severe acute pancreatitis (APACHEE II ≥ 6)

Cited by 210 publications

References 22 publications

Oral Refeeding After Onset of Acute Pancreatitis: A Review of Literature

Oral Refeeding After Onset of Acute Pancreatitis: A Review of Literature

Practice Guidelines in Acute Pancreatitis

Meta-analysis: Total Parenteral Nutrition Versus Total Enteral Nutrition in Predicted Severe Acute Pancreatitis

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