Total enteral nutrition or total parenteral nutrition for prophylaxis of infection in patients with severe acute pancreatitis?

2007 ◽  
Vol 4 (9) ◽  
pp. 488-489 ◽  
Author(s):  
Stephen JD O'Keefe
Keyword(s):  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Severe Acute Pancreatitis ◽  
Total Enteral Nutrition

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 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.

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