Nutrición enteral total vs. nutrición parenteral total en pacientes con pancreatitis aguda grave

Casas, Meritxell; Móra, Josefina; Fort, Esther; Aracil, Carlos Ferre; Busquets, David; Galter, Sara; Jáuregui, C. E.; Ayala, Edgar; Cardona, Daniel; Gich, Ignasi; Farré, Antoni

doi:10.4321/s1130-01082007000500004

Cited by 56 publications

(25 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only 6 RCTs [20, 22–26] fulfilled the criteria in the meta-analysis. 6 RCTs were included because: (1) an Acute Physiology and Chronic Health Evaluation (APACHE II) score ≥ 8; (2) trial group received TEN and control group received TPN; (3) effective ends include one of pancreatitis-related complications, non-pancreatitis-related complications, non-infection-related complications, surgery intervention, multiple-organ failure (MOF), and mortality.…”

Section: Resultsmentioning

confidence: 99%

A Meta-Analysis of Enteral Nutrition and Total Parenteral Nutrition in Patients with Acute Pancreatitis

Quan

Wang

Guo

2011

Gastroenterology Research and Practice

View full text Add to dashboard Cite

Objective. To analyze the effect of total parenteral nutrition (TPN) and enteral nutrition (EN) in patients with acute pancreatitis. Methods. Randomized controlled trials of TPN and EN in patients with acute pancreatitis were searched in NCBI and CBM databases and The Cochrane Controlled Trials Register. Six studies were enrolled into the analysis, and the details about the trial designs, characters of the subjects, results of the studies were reviewed by two independent authors and analyzed by STATA 11.0 software. Results. Compared with TPN, EN was associated with a significantly lower incidence of pancreatic infection complications (RR = 0.556, 95% CI 0.436∼0.709, P = .000), MOF (RR = 0.395, 95% CI 0.272∼0.573, P = .003), surgical interventions (RR = 0.556, 95% CI 0.436∼0.709, P = .000), and mortality (RR = 0.426, 95% CI 0.238∼0.764, P = .167). There was no statistic significance in non-pancreatitis-related complications (RR = 0.853, 95% CI 0.490∼1.483, P = .017). However, EN had a significantly higher incidence of non-infection-related complications (RR = 2.697, 95% CI 1.947∼3.735, P = .994). Conclusion. EN could be the preferred nutrition feeding method in patients with acute pancreatitis.

show abstract

Section: Resultsmentioning

confidence: 99%

A Meta-Analysis of Enteral Nutrition and Total Parenteral Nutrition in Patients with Acute Pancreatitis

Quan

Wang

Guo

2011

Gastroenterology Research and Practice

View full text Add to dashboard Cite

show abstract

“…The second phase usually after the second week of the disease, the circumscribed complications such as pancreatic necrosis began to appear. During this period, the lives of these patients are still in serious threat of necrotizing pancreas, complication, and death which is due to inflammatory immune response of pancreatic necrosis and infection [22]. In SAP, basal metabolic rate (BMR) increases due to inflammation and acute stress reaction thereby increase the overall energy consumption.…”

Section: Discussionmentioning

confidence: 99%

Parenteral Nutrition Combined with Enteral Nutrition for Severe Acute Pancreatitis

Singh

Chen

et al. 2012

ISRN Gastroenterology

View full text Add to dashboard Cite

Background and Aims. Nutritional support in severe acute pancreatitis (SAP) is controversial concerning the merits of enteral or parenteral nutrition in the management of patients with severe acute pancreatitis. Here, we assess the therapeutic efficacy of gradually combined treatment of parenteral nutrition (PN) with enteral nutrition (EN) for SAP. Methods. The clinical data of 130 cases of SAP were analyzed retrospectively. Of them, 59 cases were treated by general method of nutritional support (Group I) and the other 71 cases were treated by PN gradually combined with EN (Group II). Results. The APACHE II score and the level of IL-6 in Group II were significantly lower than Group I (P < 0.05). Complications, mortality, mean hospital stay, and the cost of hospitalization in Group II were 39.4 percent, 12.7 percent, 32 ± 9 days, and 30869.4 ± 12794.6 Chinese Yuan, respectively, which were significantly lower than those in Group I. The cure rate of Group II was 81.7 percent which is obviously higher than that of 59.3% in Group I (P < 0.05). Conclusions. This study indicates that the combination of PN with EN not only can improve the natural history of pancreatitis but also can reduce the incidence of complication and mortality.

show abstract

“…In clinic practice, EN provided a safer route to feed patients with predicted severe acute pancreatitis (pSAP) or severe acute pancreatitis (SAP) than TPN, which was demonstrated by a meta-analysis [13]. But the timing to start EN was not emphasized in this analysis and it varied among different trials and different hospitals [14]–[16]. Though it is clear that long-lasting TPN or total “gut rest” brings no benefits, questions about whether there is no need for “gut rest” at all and whether EN rather than TPN is better in the very early phase of AP still bother a lot of physicians.…”

Section: Introductionmentioning

confidence: 98%

Enteral Nutrition within 48 Hours of Admission Improves Clinical Outcomes of Acute Pancreatitis by Reducing Complications: A Meta-Analysis

Chen

et al. 2013

PLoS ONE

View full text Add to dashboard Cite

BackgroundEnteral nutrition is increasingly advocated in the treatment of acute pancreatitis, but its timing is still controversial. The aim of this meta-analysis was to find out the feasibility of early enteral nutrition within 48 hours of admission and its possible advantages.Methods and FindingsWe searched PubMed, EMBASE Databases, Web of Science, the Cochrane library, and scholar.google.com for all the relevant articles about the effect of enteral nutrition initiated within 48 hours of admission on the clinical outcomes of acute pancreatitis from inception to December 2012. Eleven studies containing 775 patients with acute pancreatitis were analyzed. Results from a pooled analysis of all the studies demonstrated that early enteral nutrition was associated with significant reductions in all the infections as a whole (OR 0.38; 95%CI 0.21–0.68, P<0.05), in catheter-related septic complications (OR 0.26; 95%CI 0.11–0.58, P<0.05), in pancreatic infection (OR 0.49; 95%CI 0.31–0.78, P<0.05), in hyperglycemia (OR 0.24; 95%CI 0.11–0.52, P<0.05), in the length of hospitalization (mean difference −2.18; 95%CI −3.48−(−0.87); P<0.05), and in mortality (OR 0.31; 95%CI 0.14–0.71, P<0.05), but no difference was found in pulmonary complications (P>0.05). The stratified analysis based on the severity of disease revealed that, even in predicted severe or severe acute pancreatitis patients, early enteral nutrition still showed a protective power against all the infection complications as a whole, catheter-related septic complications, pancreatic infection complications, and organ failure that was only reported in the severe attack of the disease (all P<0.05).ConclusionEnteral nutrition within 48 hours of admission is feasible and improves the clinical outcomes in acute pancreatitis as well as in predicted severe or severe acute pancreatitis by reducing complications.

show abstract

Nutrición enteral total vs. nutrición parenteral total en pacientes con pancreatitis aguda grave

Abstract: SAP patients with TEN feeding showed a tendency towards a better outcome than patients receiving TPN.

Cited by 56 publications

References 34 publications

A Meta-Analysis of Enteral Nutrition and Total Parenteral Nutrition in Patients with Acute Pancreatitis

A Meta-Analysis of Enteral Nutrition and Total Parenteral Nutrition in Patients with Acute Pancreatitis

Parenteral Nutrition Combined with Enteral Nutrition for Severe Acute Pancreatitis

Enteral Nutrition within 48 Hours of Admission Improves Clinical Outcomes of Acute Pancreatitis by Reducing Complications: A Meta-Analysis

Contact Info

Product

Resources

About