Effects of Enteral Nutrition vs Total Parenteral Nutrition in Outcomes of Acute Pancreatitis: A Pooled Meta-Analysis

2016 ◽  
Vol 111 ◽  
pp. S52-S53
Author(s):  
Ajai S. Rajabalan ◽  
Tamer Said Ahmed ◽  
Samir V. Patel ◽  
Thara Vidyasagaran ◽  
Vishnu R. Mani ◽  
...  
2018 ◽  
Vol 46 (9) ◽  
pp. 3948-3958 ◽  
Author(s):  
Wen Li ◽  
Jixi Liu ◽  
Shuqiao Zhao ◽  
Jingtao Li

Objective This study was performed to systematically compare the safety and efficacy of total enteral nutrition (TEN) and total parenteral nutrition (TPN) for patients with severe acute pancreatitis (SAP). Methods The PubMed database was searched up to January 2017, and nine studies were retrieved. These studies were selected according to specific eligibility criteria. The methodological quality of each trial was assessed, and the study design, interventions, participant characteristics, and final results were then analyzed by Review Manager 5.3 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Results Nine relevant randomized controlled trials involving 500 patients (244 patients in the TEN group and 256 patients in the TPN group) were included in the meta-analysis. Pooled analysis showed a significantly lower mortality rate in the TEN than TPN group [odds ratio (OR), 0.31; 95% confidence interval (CI), 0.18–0.54]. The duration of hospitalization was significantly shorter in the TEN than TPN group (mean difference, −0.59; 95% CI, −2.56–1.38). Compared with TPN, TEN had a lower risk of pancreatic infection and related complications (OR, 0.41; 95% CI, 0.22–0.77), organ failure (OR, 0.17; 95% CI, 0.06–0.52), and surgical intervention (OR, 0.17; 95% CI, 0.05–0.62). Conclusions This meta-analysis indicates that TEN is safer and more effective than TPN for patients with SAP. When both TEN and TPN have a role in the management of SAP, TEN is the preferred option.


2008 ◽  
Vol 134 (4) ◽  
pp. A-141 ◽  
Author(s):  
Nadim S. Jafri ◽  
Suhal S. Mahid ◽  
Swapna K. Gopathi ◽  
Carlton A. Hornung ◽  
Susan Galandiuk ◽  
...  

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Heming Quan ◽  
Xingpeng Wang ◽  
Chuanyong Guo

Objective. To analyze the effect of total parenteral nutrition (TPN) and enteral nutrition (EN) in patients with acute pancreatitis.Methods. Randomized controlled trials of TPN and EN in patients with acute pancreatitis were searched in NCBI and CBM databases and The Cochrane Controlled Trials Register. Six studies were enrolled into the analysis, and the details about the trial designs, characters of the subjects, results of the studies were reviewed by two independent authors and analyzed by STATA 11.0 software.Results. Compared with TPN, EN was associated with a significantly lower incidence of pancreatic infection complications (RR=0.556, 95% CI 0.436∼0.709,P=.000), MOF (RR=0.395, 95% CI 0.272∼0.573,P=.003), surgical interventions (RR=0.556, 95% CI 0.436∼0.709,P=.000), and mortality (RR=0.426, 95% CI 0.238∼0.764,P=.167). There was no statistic significance in non-pancreatitis-related complications (RR=0.853, 95% CI 0.490∼1.483,P=.017). However, EN had a significantly higher incidence of non-infection-related complications (RR=2.697, 95% CI 1.947∼3.735,P=.994).Conclusion. EN could be the preferred nutrition feeding method in patients with acute pancreatitis.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
B B Ghobreal ◽  
S F Mahmoud ◽  
H S A Elsamie ◽  
A M Metwally

Abstract Background Acute pancreatitis (AP) is an inflammatory condition of the pancreas that can cause local injury, systemic inflammatory response syndrome, and organ failure. Worldwide, AP is a common gastrointestinal condition and there is evidence that the incidence has been rising in recent years. AP is associated with substantial suffering, morbidity, and cost to the health care system. Objective Our study aims to compare between the effect of enteral (EN) and parenteral nutrition on serum triglycerides in patient with acute pancreatitis in intensive care unit of Ain Shams University (ICU). We found that enteral route is more safe than parenteral nutrition regarding serum triglycerides. Patients and Methods An informed written consent was obtained from patients and /or relatives who were included in this study. All patients were adults, more than 18 years old, admitted to ICU of Ain Shams University Hospital, either have acute pancreatitis on admission or acquired acute pancreatitis in ICU due to different causes in period of six months of approval of the protocol. Patients were divided into two groups: 30 patients started total parenteral nutrition TPN ) one day after admission consisting of 70% carbohydrate (in the form of dextrose 25%) and 30% fat (smoflipid 250 ml, 2 gm per ml). The other 30 patients started enteral nutrition rich in carbohydrates with low fat content one day after admission (peptamen) 6 scoops in 200 ml water every 2 hours, stopped from 12 am to 8 am. Serum triglyceride level was measured at first day of admission, then 3 days after admission, then one week after admission. Results Our study showed that TPN was associated with more increase of serum triglycerides level from first day of admission to 3 days after admission when compared with enteral nutrition, there is also increase in serum triglycerides from 3days to one week after admission, comparing the three periods together, there is increase in serum triglycerides with TPN group more than in enteral group. Conclusion The study showed that TPN was associated with higher mortality rate than EN, also there was an increase in serum triglycerides with TPN more than EN; suggesting that, enteral nutrition is a safer mode of nutrition in patients with acute pancreatitis.


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