scholarly journals The effect of early enteral nutrition on intestinal mucosal barrier and remote organs in rats with severe acute pancreatitis

2021 ◽  
Author(s):  
Jianbo Song ◽  
xiaoguang Lu ◽  
Libin Zhan ◽  
Xin Kang ◽  
Yilong Zhong ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Severe Acute Pancreatitis ◽  
Mucosal Barrier ◽  
Early Enteral Nutrition ◽  
Lung Pathology ◽  
Intestinal Mucosal Barrier ◽  
Significant Difference

Abstract Background The mechanism of early enteral nutrition on intestinal mucosal barrier is still not fully understood and the direct evidence to demonstrate the protective effects of early enteral nutrition against remote organs injury induced by severe acute pancreatitis is lacking. Methods Rats were randomly divided into three groups: 1) only flip pancreas and free diet (n = 8); 2) severe acute pancreatitis and total parenteral nutrition (n = 15); 3) severe acute pancreatitis and early enteral nutrition (n = 15). Severe acute pancreatitis was induced by the retrograde injection of pancreaticobiliary duct with sodium taurocholate. Nutritional supplementation was administered starting 12 hours after induction of pancreatitis. The samples were obtained after the treatment of nutrition 72 hours. Results The mortality was not significant difference between the experimental groups. The pathology of ileum and the content of serum diamine oxidase were significantly lower in early enteral nutrition group than total parenteral nutrition group. The expression of tight junction ZO-1, Occludin and Claudin-1 proteins and the intraepithelial CD8+ and TCRγδ+ lymphocytes were significantly higher in early enteral nutrition group than total parenteral nutrition group. The content of the serum amylase and endotoxin were significantly lower in early enteral nutrition group than total parenteral nutrition group. There was a tendency of decreased pancreas and lung pathology scores in early enteral nutrition group, but the difference between total parenteral nutrition and early enteral nutrition groups was not significant. Conclusion The early enteral nutrition could significantly improve the expression of the tight junctions and intraepithelial lymphocytes, accompanied by improved intestinal mucosal barrier and endotoxin, but failed to the pancreas and lung injury compared to total parenteral nutrition in the rat model of severe acute pancreatitis.

scholarly journals Safety and efficacy of total parenteral nutrition versus total enteral nutrition for patients with severe acute pancreatitis: a meta-analysis

2018 ◽  
Vol 46 (9) ◽  
pp. 3948-3958 ◽  
Author(s):  
Wen Li ◽  
Jixi Liu ◽  
Shuqiao Zhao ◽  
Jingtao Li
Keyword(s):  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Severe Acute Pancreatitis ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Safety And Efficacy ◽  
Pubmed Database ◽  
Total Enteral Nutrition

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.

956 Enteral Nutrition Is Superior to Total Parenteral Nutrition in Severe Acute Pancreatitis: A Systematic Review and Meta-Analysis

2008 ◽  
Vol 134 (4) ◽  
pp. A-141 ◽  
Author(s):  
Nadim S. Jafri ◽  
Suhal S. Mahid ◽  
Swapna K. Gopathi ◽  
Carlton A. Hornung ◽  
Susan Galandiuk ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Severe Acute Pancreatitis ◽  
Meta Analysis

scholarly journals Effectiveness of artificial nutrition in patients with acute pancreatitis

2017 ◽  
Vol 3 (2) ◽  
pp. 94
Author(s):  
Konstantina Skontzou ◽  
George Vassilopoulos ◽  
Anastasia Kotanidou ◽  
Christina Marvaki
Keyword(s):  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Severe Acute Pancreatitis ◽  
Multiple Organ ◽  
Cochrane Library ◽  
Artificial Nutrition ◽  
Early Enteral Nutrition ◽  
Early Application ◽  
Septic Complications

Introduction: Early application of enteral nutrition programme has begun to gain ground in recent years in the treatment of severe acute pancreatitis by putting into question the effectiveness of parenteral nutrition.Aim: The purpose of the present review was to investigate the effectiveness of artificial nutrition in curbing of complications and improvement of patients with severe acute pancreatitis.Material and Method: There was a research in electronic databases Scopus, Pubmed, The Cochrane Library and Scopemed for the time period 2010-2015. The key words selected for the data search were “acute pancreatitis”, “nutrition”, “feeding” and “clinical trials”. For the preparation of the review, 14 research studies were used.Results: The superiority of enteral feeding versus parenteral is documented by the reduction of inflammatory mediators and septic complications while early enteral nutrition (within 48 hours) is associated with lower rates of complications, multiple-organ dysfunction and mortality. Patients undergoing enteral nutrition are hospitalized for a shorter period of time compared to those undergoing parenteral nutrition. The duration of hospitalization in the ICU is even shorter for patients who also receive immunonutrition which helps to reduce bacterial translocation, systemic inflammatory response and complications.Conclusions: The granting of early enteral nutrition with or without immunonutrition contributes decisively to reverse the sharp deterioration of patients with severe acute pancreatitis. Early enteral nutrition is associated with fewer complications compared to total parenteral nutrition.

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