Hypocaloric jejunal feeding is better than total parenteral nutrition in acute pancreatitis: results of a randomized comparative study

• DOI: 10.1111/j.1572-0241.2002.05979.x
• Publication Date: 2004-03-26T14:10:02Z
• Authors: Souheil Abou-Assi; Kimberly Craig; Stephen J.D. O'Keefe
• Keywords: Subgroup analysis; Enteral administration

The aims of this study were to define the indications for, and evaluate cost-effectiveness of, nutritional support in patients with acute pancreatitis.All admissions during 12-month period from January through December 2000, entered into a common management protocol consisting an initial 48-h fast i.v. fluids analgesics. After 48 h, those who improving restarted on oral feeding (group O). remaining randomized receive nasojejunal EN) or parenteral TPN). randomization was continued until 50 had been accrued. Outcomes three groups compared respect length hospital stay, duration feeding, complications, costs.A total 156 evaluated first 12 months. Of these, 87% mild disease, 10% moderate, 3% severe; 62% related alcohol abuse, 18% gallstones, 8% idiosyncratic drug reactions. patients, 75% improved h bowel rest fluids, discharged within 4 days. remainder jejunal elemental (n = 26) 27) feeding. Duration shorter EN (6.7 vs 10.8 days, p < 0.05) nutrition costs lower, representing average cost saving $2362.00 per patient fed. less effective meeting estimated requirements (54 88%, 0.0001), but metabolic (p 0.003) septic complications 0.01) lower. Subgroup analysis severe disease showed similar findings.Despite concerns that expenditure is increased food-stimulated pancreatic secretion might exacerbate process, hypocaloric enteral seems be safer expensive than pancreatitis.