Nutrición enteral temprana en pacientes con pancreatitis agudas leves: estudio clínico randomizado

Cecenarro, Rodolfo Raúl; Bonci, Laura; Kasparian, Andres C; H, Luis Gramática

doi:10.31053/1853.0605.v75.n3.18420

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…Within the RCTs, diverse treatment modalities were administered, including NPO to 244 patients, TPN to 450 patients, NJ feeding to 590 patients, NG feeding to 209 patients, and oral feeding to 101 patients. Notably, 18 trials specifically addressed SAP [17, 19–21, 23, 24, 22, 32–34, 36, 38, 44, 45, 47, 48, 50, 52], 6 RCTs focused on non‐severe pancreatitis [41, 42, 46, 49, 51, 53], whereas the severity classification remained unspecified in the remaining three trials [35, 40, 54]. Initiating nutritional support within 24 h was practiced in 10 of the 27 RCTs, whereas 6 studies commenced nutritional intervention within 48 h. Additionally, nine trials did not restricte initiation of nutritional support within 48 h, and two did not specify the exact timing of nutritional intervention.…”

Section: Resultsmentioning

confidence: 99%

Impact of nutritional support routes on mortality in acute pancreatitis: A network meta‐analysis of randomized controlled trials

Hsieh,

Yang,

Kang

et al. 2024

J Intern Med

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BackgroundNutritional administration in acute pancreatitis (AP) management has sparked widespread discussion, yet contradictory mortality results across meta‐analyses necessitate clarification. The optimal nutritional route in AP remains uncertain. Therefore, this study aimed to compare mortality among nutritional administration routes in patients with AP using consistency model.MethodsThis study searched four major databases for relevant randomized controlled trials (RCTs). Two authors independently extracted and checked data and quality. Network meta‐analysis was conducted for estimating risk ratios (RRs) with 95% confidence interval (CI) based on random‐effects model. Subgroup analyses accounted for AP severity and nutrition support initiation.ResultsA meticulous search yielded 1185 references, with 30 records meeting inclusion criteria from 27 RCTs (n = 1594). Pooled analyses showed the mortality risk reduction associated with nasogastric (NG) (RR = 0.34; 95%CI: 0.16–0.73) and nasojejunal (NJ) feeding (RR = 0.46; 95%CI: 0.25–0.84) in comparison to nil per os. Similarly, NG (RR = 0.45; 95%CI: 0.24–0.83) and NJ (RR = 0.60; 95%CI: 0.40–0.90) feeding also showed lower mortality risk than total parenteral nutrition. Subgroup analyses, stratified by severity, supported these findings. Notably, the timing of nutritional support initiation emerged as a significant factor, with NJ feeding demonstrating notable mortality reduction within 24 and 48 h, particularly in severe cases.ConclusionFor severe AP, both NG and NJ feeding appear optimal, with variations in initiation timings. NG feeding does not appear to merit recommendation within the initial 24 h, whereas NJ feeding is advisable within the corresponding timeframe following admission. These findings offer valuable insights for optimizing nutritional interventions in AP.

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Section: Resultsmentioning

confidence: 99%

Impact of nutritional support routes on mortality in acute pancreatitis: A network meta‐analysis of randomized controlled trials

Hsieh,

Yang,

Kang

et al. 2024

J Intern Med

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Impact of naso-jejunal tube enteral nutrition support on clinical outcomes and prognosis in patients with severe acute pancreatitis

Chen,

Yu,

Chen

et al. 2024

Preprint

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The aim was to investigate the effects of enteral nutrition support by naso-jejunal tube on the duration of hospitalization, infection, cost, and clinical prognosis in patients with SAP. Patients were allocated into the treatment group, receiving naso-jejunal tube feeding, or the control group that underwent total parenteral nutrition therapy. Naso-jejunal tube enteral nutrition support started within 48 hours of hospital admission. We compared differences in general clinical data before admission, including primary outcomes and secondary outcomes after treatment. A total of 332 patients with SAP were enrolled and general clinical data, such as age, sex, and etiology, were similar in both groups (P > 0.05). Compared with the control group, the time to disappear of abdominal pain and distension, fever, nausea and vomiting, peritoneal irritation signs were significantly shorter in the treated group. Furthermore, the mean hospitalization time, and the mean hospitalization and drug costs were significantly lower. Compared with the pretreatment period, the MOS item short from health survey (SF-36) scale scores were significantly improved in both groups after treatment (P < 0.001), but the SF-36 scale scores of patients in the treatment group were higher than those in the control group. Incidence of pancreatic necrotic infection and local complications, including pneumonia, bacteremia, and cholangitis was significantly lower compared to the control group. MOF and death in the treated group were also significantly lower. naso-jejunal tube enteral nutrition support can improve the nutritional status and quality of life of patients with SAP, and avoid the waste of medical resources.

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¿Es necesario el soporte nutricional en pancreatitis aguda leve?

Flechas Ordoñez,

Malaver Rojas,

Botello Lázaro

2024

CBS

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Introducción: La pancreatitis aguda es un proceso fisiopatológico inflamatorio del páncreas, con una elevada incidencia en la población y una carga significativa de enfermedad asociada, numerosos estudios han establecido la importancia del soporte nutricional enteral debido a su capacidad de preservar la mucosa intestinal, prevenir la disrupción del epitelio y la translocación bacteriana responsables de las complicaciones clínicas. Métodos: Se realizó revisión bibliográfica en noventa artículos publicados entre 2015 y 2023 en PubMed, National Library of Medicine y Google académico con el propósito de evidenciar de manera sistemática si es necesario el soporte nutricional en pancreatitis aguda leve. Resultados: Posterior a la aplicación metodológica los doce artículos estudiados resaltan la relevancia del tipo de soporte, efectividad en la disminución del dolor y relación de la estancia hospitalaria en el soporte nutricional enteral. Conclusión: La revisión sistemática respalda la relevancia del soporte nutricional enteral en pacientes con pancreatitis aguda leve, subrayando la importancia de evaluar la tolerancia del paciente y avanzar gradualmente hacia una dieta oral.

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Nutrición enteral temprana en pacientes con pancreatitis agudas leves: estudio clínico randomizado

Cited by 3 publications

References 24 publications

Impact of nutritional support routes on mortality in acute pancreatitis: A network meta‐analysis of randomized controlled trials

Impact of nutritional support routes on mortality in acute pancreatitis: A network meta‐analysis of randomized controlled trials

Impact of naso-jejunal tube enteral nutrition support on clinical outcomes and prognosis in patients with severe acute pancreatitis

¿Es necesario el soporte nutricional en pancreatitis aguda leve?

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