Xian L Zhao1, Shi F Zhu1, Gui J Xue1, Juan Li1, Yi L Liu1, Mei H Wan1, Wei Huang2, Qing Xia1, Wen F Tang3. 1. Pancreatic Diseases Research Group, Department of Integrative Medicine, West China Hospital, Sichuan University, Chengdu, PR China. 2. Pancreatic Diseases Research Group, Department of Integrative Medicine, West China Hospital, Sichuan University, Chengdu, PR China; Liverpool NIHR Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom. 3. Pancreatic Diseases Research Group, Department of Integrative Medicine, West China Hospital, Sichuan University, Chengdu, PR China. Electronic address: Wftang900@gmail.com.
Abstract
OBJECTIVE: Early enteral nutrition is beneficial for acute pancreatitis (AP), but the optimal timing and criteria remain unclear. The aim of this study was to explore the feasibility and safety of early oral refeeding (EORF) based on hunger in patients with moderate or severe AP. METHODS: In a prospective, single-center, controlled, randomized clinical trial (ChiCTR-TRC-12002994), eligible patients with moderate or severe AP were randomized to either EORF or conventional oral refeeding (CORF). Patients in the EORF group restarted an oral diet when they felt hungry, regardless of laboratory parameters. Those in the CORF group restarted an oral diet only when clinical and laboratory symptoms had resolved. Clinical outcomes were compared between the two groups. RESULTS: In all, 146 eligible patients with moderate or severe AP were included and randomized to the EORF (n = 70) or CORF (n = 76) group. There were eight dropouts after randomization (three in EORF group; five in CORF group). The groups had similar baseline characteristics. The total length of hospitalization (13.7 ± 5.4 d versus 15.7 ± 6.2 d; P = 0.0398) and duration of fasting (8.3 ± 3.9 d versus 10.5 ± 5.1 d; P = 0.0047) were shorter in the EORF group than in the CORF group. There was no difference in the number of adverse events or complications between the two groups. The mean blood glucose level after oral refeeding was higher in the EORF group than in the CORF group (P = 0.0030). CONCLUSIONS: This controlled, randomized clinical trial confirmed the effectiveness and feasibility of EORF based on hunger in patients with moderate or severe AP. EORF could shorten the length of hospitalization in patients with moderate or severe AP.
RCT Entities:
OBJECTIVE: Early enteral nutrition is beneficial for acute pancreatitis (AP), but the optimal timing and criteria remain unclear. The aim of this study was to explore the feasibility and safety of early oral refeeding (EORF) based on hunger in patients with moderate or severe AP. METHODS: In a prospective, single-center, controlled, randomized clinical trial (ChiCTR-TRC-12002994), eligible patients with moderate or severe AP were randomized to either EORF or conventional oral refeeding (CORF). Patients in the EORF group restarted an oral diet when they felt hungry, regardless of laboratory parameters. Those in the CORF group restarted an oral diet only when clinical and laboratory symptoms had resolved. Clinical outcomes were compared between the two groups. RESULTS: In all, 146 eligible patients with moderate or severe AP were included and randomized to the EORF (n = 70) or CORF (n = 76) group. There were eight dropouts after randomization (three in EORF group; five in CORF group). The groups had similar baseline characteristics. The total length of hospitalization (13.7 ± 5.4 d versus 15.7 ± 6.2 d; P = 0.0398) and duration of fasting (8.3 ± 3.9 d versus 10.5 ± 5.1 d; P = 0.0047) were shorter in the EORF group than in the CORF group. There was no difference in the number of adverse events or complications between the two groups. The mean blood glucose level after oral refeeding was higher in the EORF group than in the CORF group (P = 0.0030). CONCLUSIONS: This controlled, randomized clinical trial confirmed the effectiveness and feasibility of EORF based on hunger in patients with moderate or severe AP. EORF could shorten the length of hospitalization in patients with moderate or severe AP.
Authors: Maisam Abu-El-Haija; Aliye Uc; Steven L Werlin; Alvin Jay Freeman; Miglena Georgieva; Danijela Jojkić-Pavkov; Daina Kalnins; Brigitte Kochavi; Bart G P Koot; Stephanie Van Biervliet; Jaroslaw Walkowiak; Michael Wilschanski; Veronique D Morinville Journal: J Pediatr Gastroenterol Nutr Date: 2018-07 Impact factor: 2.839
Authors: Chirag J Jivanji; Varsha M Asrani; Sayali A Pendharkar; Melody G Bevan; Nicola A Gillies; Danielle H E Soo; Ruma G Singh; Maxim S Petrov Journal: Dig Dis Sci Date: 2017-03-14 Impact factor: 3.199
Authors: Ioannis Pothoulakis; Haq Nawaz; Pedram Paragomi; Kwonho Jeong; Rupjyoti Talukdar; Rakesh Kochhar; Mahesh Kumar Goenka; Aiste Gulla; Vikesh K Singh; Jose A Gonzalez; Miguel Ferreira; Sorin T Barbu; Tyler Stevens; Silvia C Gutierrez; Narcis O Zarnescu; Gabriele Capurso; Jeffrey Easler; Konstantinos Triantafyllou; Mario Pelaez-Luna; Shyam Thakkar; Carlos Ocampo; Enrique de-Madaria; Bechien U Wu; Gregory A Cote; Kaleab Abebe; Gong Tang; Ali Lahooti; Anna E Phillips; Georgios I Papachristou Journal: United European Gastroenterol J Date: 2021-02-12 Impact factor: 4.623