Document Detail


Early oral feeding in acute pancreatitis: an alternative approach to tube feeding. Preliminary report.
MedLine Citation:
PMID:  16761474     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Jejunal feeding is accepted in the treatment of severe acute pancreatitis (AP). Early oral feeding (EOF) is deemed to be detrimental in the early phase of AP. The aim of this study was to assess the safety and effectiveness of EOF in the treatment of AP. MATERIALS AND METHODS: 29 AP patients were prospectively enrolled within 1.96 days from the onset of disease. APACHE II score, SIRS, MODS, serum CRP and lipase were evaluated. All patients received EOF when gastro-enteric transit was not severely impaired. ICU, hospital stay and main outcomes were assessed. RESULTS: APACHE II score was > or = 8 in 10 patients at the admission ranging 0-13 points for the whole group. Alcohol (62%) and gallstones (38%) were the main etiologic factors. SIRS and MODS were diagnosed in 65% and pleural effusion in 24% of patients. EOF was started on average 3.27 days after admission providing 571 ml (280.0-1115.0 ml) of enteral formula daily for 10.38 days. Median lipase activity was 690 U/l (90-10175 U/l) and CRP concentration reached 91.25 mg/dL (3.5-210 mg/dL) before EOF. Progressive decrease of lipase activity and CRP concentration was observed during the EOF course, reaching median CRP 18.6 mg/L (4.6-96.7mg/L) by discharge. Two patients underwent surgical intervention. Minor side effects of EOF were successfully managed in 4 patients. No mortality was observed. CONCLUSION: EOF could be a safe and effective alternative of nutritional support in AP patients when gastro-enteric transit is not severely impaired. For better EOF assessment further clinical trials are required.
Authors:
G Pupelis; K Snippe; H Plaudis; M Rudakovska
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Acta chirurgica Belgica     Volume:  106     ISSN:  0001-5458     ISO Abbreviation:  Acta Chir. Belg.     Publication Date:    2006 Mar-Apr
Date Detail:
Created Date:  2006-06-09     Completed Date:  2006-10-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370571     Medline TA:  Acta Chir Belg     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  181-6     Citation Subset:  IM    
Affiliation:
Clinical Hospital "Gailezers", Department of Surgery, Riga, Latvia. pupelis@gailes.lv
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
C-Reactive Protein / metabolism
Enteral Nutrition / methods*
Feasibility Studies
Female
Humans
Lipase / blood
Male
Middle Aged
Pancreatitis / therapy*
Pancreatitis, Acute Necrotizing / therapy
Prospective Studies
Safety
Time Factors
Chemical
Reg. No./Substance:
9007-41-4/C-Reactive Protein; EC 3.1.1.3/Lipase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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