Early Semielemental Diet via Nasogastric Tube Feeding in Severe Acute Pancreatitis: Preliminary Report
Keywords:
Severe acute pancreatitis, Semielemental diet, Nasogastric tube feedingAbstract
Objective: The objective was to study if early semielemental diet feeding is safe and effective in improving the systemic inflammatory response in severe acute pancreatitis.
Materials and Methods: A trial of nutritional support in patients with severe acute pancreatitis in the intensive care unit, Department of Surgery, Chiang Mai University Hospital, from October 2003 to December 2004 was conducted and analyzed. Acute pancreatitis was defined by clinical symptoms and signs and confirmed by serum amylase, urine amylase, and C- reactive protein, and then classified as severe acute pancreatitis by Ranson and APACHE II scores. Seven patients with severe acute pancreatitis were randomized into two groups. The conventional group was given total parenteral nutrition (TPN) and the interventional group was given partial parenteral nutrition (PPN), with early semielemental diet feeding via nasogastric tube when bowel function was present.
Results: Four of 7 patients were given TPN alone. Three patients were given PPN with early semi elemental diet until recovery. Etiologies of pancreatitis included biliary in 1 case and alcoholic in 6 cases. The Ranson and APACHE II scores were similar in both groups. Mean length of stay was 13.25 days in the conventional group, and 18 days in the interventional group. There were no serious complications or systemic inflammatory response syndrome in either group. One patient in the conventional group developed pancreatic pseudocyst with spontaneous regression. Another patient in the interventional group developed the same problem and was successfully managed by drainage procedure.
Conclusion: This study supported the safety and effectiveness of nutritional management for patients with severe acute pancreatitis by early semielemental enteral feeding.
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