PURPOSE:Enteral nutrition (EN) is effective, easy to provide, cheaper, and associated with fewer complications in comparison with parenteral nutrition in severe acute pancreatitis (SAP). However, the nasogastric (NG) route for enteral supplements still remains to be established, and most studies have used the nasojejunal (NJ) route. The purpose of this study was to compare early NJ with NG feeding in SAP. PATIENTS AND METHODS: A total of 31 patients with SAP were randomized to feeding by either NG (15 patients) or NJ (16 patients). A semi-elemental formula was used through an enteral tube in both groups. Nutritional parameters (anthropometry, serum prealbumin and albumin levels) were recorded at baseline and after 7 days. Recurrence of pain and tolerance of feeding was noted. RESULTS:Recurrence of pain occurred in only 1 patient each in the 2 groups. Diarrhea occurred in 3 and 4 patients in the NJ and NG groups, respectively. There were 4 deaths in the NJ group and 5 in the NG group. Two patients in the NJ group and 1 in the NG group underwent surgery. There was no difference in the outcome measures (ie, discharge, surgery, and death). There was a decline in nutritional parameters in both groups. CONCLUSIONS: EN at a slow infusion is well tolerated by both NJ and NG routes in patients with SAP. Neither NJ nor NG feeding leads to recurrence or worsening of pain in SAP. Nutritional parameters remained unaffected because of inadequate calorie intake during the first week of feeding.
RCT Entities:
PURPOSE: Enteral nutrition (EN) is effective, easy to provide, cheaper, and associated with fewer complications in comparison with parenteral nutrition in severe acute pancreatitis (SAP). However, the nasogastric (NG) route for enteral supplements still remains to be established, and most studies have used the nasojejunal (NJ) route. The purpose of this study was to compare early NJ with NG feeding in SAP. PATIENTS AND METHODS: A total of 31 patients with SAP were randomized to feeding by either NG (15 patients) or NJ (16 patients). A semi-elemental formula was used through an enteral tube in both groups. Nutritional parameters (anthropometry, serum prealbumin and albumin levels) were recorded at baseline and after 7 days. Recurrence of pain and tolerance of feeding was noted. RESULTS: Recurrence of pain occurred in only 1 patient each in the 2 groups. Diarrhea occurred in 3 and 4 patients in the NJ and NG groups, respectively. There were 4 deaths in the NJ group and 5 in the NG group. Two patients in the NJ group and 1 in the NG group underwent surgery. There was no difference in the outcome measures (ie, discharge, surgery, and death). There was a decline in nutritional parameters in both groups. CONCLUSIONS: EN at a slow infusion is well tolerated by both NJ and NG routes in patients with SAP. Neither NJ nor NG feeding leads to recurrence or worsening of pain in SAP. Nutritional parameters remained unaffected because of inadequate calorie intake during the first week of feeding.
Authors: Veronique D Morinville; Sohail Z Husain; Harrison Bai; Bradley Barth; Rabea Alhosh; Peter R Durie; Steven D Freedman; Ryan Himes; Mark E Lowe; John Pohl; Steven Werlin; Michael Wilschanski; Aliye Uc Journal: J Pediatr Gastroenterol Nutr Date: 2012-09 Impact factor: 2.839
Authors: Jorge D Machicado; Amir Gougol; Pedram Paragomi; Stephen J OʼKeefe; Kenneth Lee; Adam Slivka; David C Whitcomb; Dhiraj Yadav; Georgios I Papachristou Journal: Pancreas Date: 2018-10 Impact factor: 3.327