Evaluation of Early Enteral Feeding Through Nasogastric and Nasojejunal Tube in Severe Acute Pancreatitis

Pancreas ◽  
2012 ◽  
Vol 41 (1) ◽  
pp. 153-159 ◽  
Author(s):  
Namrata Singh ◽  
Brij Sharma ◽  
Manik Sharma ◽  
Vikas Sachdev ◽  
Payal Bhardwaj ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Enteral Feeding ◽  
Early Enteral Feeding ◽  
Nasojejunal Tube

scholarly journals Early versus delayed enteral feeding in acute pancreatitis

2018 ◽  
Vol 5 (3) ◽  
pp. 942
Author(s):  
Manjunath B. D. ◽  
Abhishek G.
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Enteral Feeding ◽  
Necrotizing Pancreatitis ◽  
Length Of Hospital Stay ◽  
Feeding Tube ◽  
Clinical Findings ◽  
Early Enteral Feeding ◽  
Multiple Organs ◽  
Feeding Group

Background: Early enteral feeding through a nasoenteric feeding tube is often used in patients with acute pancreatitis, as compared to previous notion of pancreatic rest. This study aims to compare various outcomes of early and late enteral feeding in severe acute pancreatitis.Methods: This study was a randomized trial conducted at Victoria hospital, Bengaluru between July 2016 and June 2017. Patients with severe acute pancreatitis were randomized into early enteral feeding and late enteral feeding groups in the ratio of 1:1. Early enteral feeding group were started on oral feeds within 24 hours of admission. Late enteral feeding group were started on oral feeds after 72 hours of admission. Patient demographics, clinical findings, investigations, length of hospital stay, complications were assessed and compared.Results: In 124 out of 132 patients were included who met inclusion criteria. The mean age of patients was 28.6 years. There were 120 males (96.7%) and 4 females (3.2%). There were no significant differences in age, sex ratio and comorbidities between the two groups. Early enteral feeds group showed lesser number of gastrointestinal adverse effects after initiation of enteral feeds, lesser number of days taken to develop full tolerance to enteral feeds, lesser number of days of admission, lesser complications like necrotizing pancreatitis, single or multiple organs failure, lesser number of ICU admissions, requiring mechanical ventilation, including lesser mortality when compared to delayed enteral feeds group.Conclusions: Patients with severe acute pancreatitis can safely be started on early enteral feeds within 24 hours of admission.

scholarly journals Nutrition and Antibiotics for Acute Pancreatitis

2021 ◽  
Vol 26 (3) ◽  
pp. 176-180
Author(s):  
Hoonsub So ◽  
Hye Kyung Lee ◽  
Tae Jun Song
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Enteral Feeding ◽  
Broad Spectrum ◽  
Nutritional Support ◽  
Tube Feeding ◽  
Prophylactic Antibiotics ◽  
Nasojejunal Tube ◽  
Solid Diet ◽  
Systemic Infections

Acute pancreatitis is a sudden inflammatory disease that could be developed into a fatal condition. Traditional dogma was to rest the pancreas by fasting. However, evidence shows the benefits of early enteral feeding resulting in a shorter hospital stay, improved mortality, multi-organ failure, systemic infections, and the need for operative interventions. Clinicians should encourage enteral feeding as soon as possible even in severe acute pancreatitis if there are no contraindications. An immediate solid diet could be attempted. Regarding tube feeding, the nasojejunal tube did not show superiority to the nasogastric tube. Different formulas and probiotics need more investigation. Guidelines are against using prophylactic antibiotics, but Korean centers still report overuse of antibiotics. However, there is still a debate about using prophylactic antibiotics in severe acute pancreatitis. Broad-spectrum antibiotics should be initiated when an infection is suspected. In conclusion, enteral nutritional support and optimal use of antibiotics are the keys to the management of acute pancreatitis.

scholarly journals Efficacy of Nasogastric and Nasojejunal Enteral Feeding in the Early Phase of Acute Pacreatitis

2021 ◽  
Vol 17 (6) ◽  
pp. 27-32
Author(s):  
O. G. Sivkov ◽  
A. O. Sivkov ◽  
I. B. Popov ◽  
E. Yu. Zaitsev
Keyword(s):  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Severe Acute Pancreatitis ◽  
Enteral Feeding ◽  
Early Phase ◽  
Early Period ◽  
Study Groups ◽  
Gastric Volume ◽  
Residual Gastric Volume ◽  
Nasojejunal Tube

Enteral nutrition in the early phase of predicted severe acute pancreatitis can be administered via a nasogastric or nasojejunal tube. Finding the most effective method in terms of daily balance, the volume of feeding and residual gastric volume in the early period of moderate and severe acute pancreatitis is a current challenge.The aim of the study was to estimate the efficacy of nasogastric and nasojejunal early enteral feeding duringthe early phase of predicted severe acute pancreatitis.Material and methods. The study was prospective, single-center, and randomized. The data were collected from November 2012 to October 2018. The study included 64 ICU patients in the early period of acute pancreatitis exhibiting predictors of severity. During randomization, the patients were assigned to either nasogastric (group 1) or nasojejunal (group 2) feeding for the next four days. The volume of enteral feeding on Day 1 was 250 ml/day, and on each successive day it was increased by 250 ml/day. During group allocation, the disease severity and the way of nutrient administration were taken into account. Daily balance was calculated using the difference between enterally administered and residual gastric volume. Statistical analysis was performed using SPSS v.23 software package. The null hypothesis was rejected at P0.05.Results. The volume of enteral nutrition administered over 4 days did not differ between the study groups. Patients with severe acute pancreatitis had significantly better nutrient absorption over 4 days when the postpyloric route was used (1.63±0.98 l/d) vs the nasogastric one (0.55±0.29 l/d) (P=0.001). In moderate pancreatitis, the enteral nutrition absorption over 4 days did not differ (P=0.107) between the groups with nasogastric (2.06±0.87 l/day) and nasojejunal (2.6±0.45 l/day) feeding.Conclusion. Nasojejunal route is the preferred way to start enteral feeding in patients with severe acute pancreatitis. In moderate acute pancreatitis, feeding can be initiated via the gastric route and only in case of intolerance it should be switched to the nasojejunal one.

scholarly journals Role of early enteral feeding in mild and moderate acute pancreatitis

2021 ◽  
Vol 8 (11) ◽  
pp. 3387
Author(s):  
Aswin George Roy ◽  
Haridas T. V.
Keyword(s):  
Acute Pancreatitis ◽  
Hospital Stay ◽  
Enteral Feeding ◽  
Significant Risk ◽  
Length Of Hospital Stay ◽  
Advantages And Disadvantages ◽  
Early Enteral Feeding ◽  
Systemic Complication ◽  
Infective Complications

Background: Timing of enteral feeding in acute pancreatitis was always a matter of controversy. Increasing evidence suggests that early enteral feeding reduces systemic and local complications of pancreatitis and thereby hospital stay. Hence the study has been undertaken to determine the feasibility, advantages and disadvantages of early enteral feeding in mild and moderate acute pancreatitis. Methods: Patients admitted with symptoms and signs suggestive of mild and moderate acute pancreatitis who were started on early enteral feeding (within 48 hours of admission) were included in study. Blood investigation results are used to classify patients accordingly to mild and moderate acute pancreatitis based on Ransons’s score. Patients were followed up and categorized based on development of complications, length of hospital stay.Results: Majority of the patients who were started on early enteral feeding showed significant decrease in complications and hospital stay. Study also suggested that age is a significant risk in development of complications. Gender is not significant in the development of complications.Conclusions: There is significant decrease in rate of systemic complication, local infective and non-infective complications, length of hospital stay among acute pancreatitis patients who were started on early enteral feeding (within 48 hours).

ENTERAL NUTRITION WITH NASOGASTRIC VS NASOJEJUNAL TUBE IN SEVERE ACUTE PANCREATITIS: A PRAGMATIC STUDY

2009 ◽  
Vol 41 ◽  
pp. S101
Author(s):  
M. Piciucchi ◽  
E. Merola ◽  
M. Marignani ◽  
F. Panzuto ◽  
F. Baccini ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Severe Acute Pancreatitis ◽  
Nasojejunal Tube ◽  
Pragmatic Study

scholarly journals Nutritional Support in Patients with Severe Acute Pancreatitis-Current Standards

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1498
Author(s):  
Beata Jabłońska ◽  
Sławomir Mrowiec
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Infectious Complications ◽  
Nutritional Risk ◽  
Gastrointestinal Dysmotility ◽  
Gut Barrier Function ◽  
Nasojejunal Tube ◽  
Nutritional Disturbances ◽  
Current Standards

Severe acute pancreatitis (SAP) leads to numerous inflammatory and nutritional disturbances. All SAP patients are at a high nutritional risk. It has been proven that proper nutrition significantly reduces mortality rate and the incidence of the infectious complications in SAP patients. According to the literature, early (started within 24–48 h) enteral nutrition (EN) is optimal in most patients. EN protects gut barrier function because it decreases gastrointestinal dysmotility secondary to pancreatic inflammation. Currently, the role of parenteral nutrition (PN) in SAP patients is limited to patients in whom EN is not possible or contraindicated. Early versus delayed EN, nasogastric versus nasojejunal tube for EN, EN versus PN in SAP patients and the role of immunonutrition (IN) in SAP patients are discussed in this review.

scholarly journals TO COMPARE EARLY ENTERAL FEED WITH EARLY PARENTERAL FEED IN PATIENTS OF ACUTE PANCREATITIS; A PROSPECTIVE RANDOMISED OBSERVATIONAL STUDY.

2019 ◽  
Vol 3 (12) ◽  
Author(s):  
Devesh Kumar Tiwari ◽  
Rajan B. Somani
Keyword(s):  
Acute Pancreatitis ◽  
Hospital Stay ◽  
Enteral Feeding ◽  
Intestinal Barrier ◽  
Parenteral Feeding ◽  
Intestinal Barrier Function ◽  
Duration Of Hospital Stay ◽  
Early Enteral Feeding ◽  
Randomized Clinical Study ◽  
Feeding Group

Acute pancreatitis has been recognised since antiquity but the importance of pancreas and the severity of its inflammatory disorders were realized only in the middle of the 19th century. In accordance with this wide variation in clinical presentation, the treatment of acute pancreatitis requires a multidisciplinary approach. But even today with technical advances in medical and surgical fields acute pancreatitis remains a major cause of morbidity and mortality. Increasing evidence suggests that enteral feeding maintains the intestinal barrier function and prevents or reduces bacterial translocation from the gut. Our aim is to compare the effects of early enteral feeding with early parenteral feeding in acute pancreatitis in terms of occurrence of infective & non infective complications in both types of feeding groups and to assess the average duration of hospital stay and cost in both groups. This prospective randomized clinical study was carried out on patients of 50 diagnosed cases of acute pancreatitis admitted in Sir T Hospital from October 2017 to August 2019. Patients included in study were randomly divided into two group A (Enteral feeding) and group B (Parenteral feeding). After initiation of respective nutrition patients were observed for infective and non infective complication incidence, duration of hospital stay and other morbidities. Enteral feeding decrease the incidence of infective and non pancreatic complications, decreases duration of hospital stay. Patients tolerating soft diet earlier in early enteral feeding group compared to early parenteral feeding group. Cost of treatment is also less in enteral feeding. So in acute pancreatitis early enteral feeding is superior to early parenteral feeding. Keywords: Acute pancreatitis ,  Enteral , Parenteral, Feeding.

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