[Early jejunal feeding in acute pancreatitis: prevention of septic complications and multiorgan failure].
Authors evaluate the effect of early jejunal feeding on septic complications and mortality in acute pancreatitis, based on the results of a two-phase, prospective, randomized study. In the first part of the study they compared the conventional parenteral nutrition with early (started within 24 hours) enteral nutrition in a prospective, randomized trial on 89 patients. Forty-eight patients were randomized into the parenteral group "A" (Rindex 10, Infusamin S, Intralipid 10%: 30 kcal/kg) and 41 patients into the enteral group "B" (fed by nasogastric jejunal tube Survimed OPD, 30 kcal/kg). The rate of septic complications (infected necrosis, abscess, infected pseudocyst) were significantly lower in the enteral group (p = 0.08 chi-square test). In the second phase of the study early jejunal feeding was combined with imipenem prophylaxis (Tienam, 2 x 500 mg i.v.) in the necrotizing cases detected by CT scan. According to the results of 92 patients the rate of septic complications (p = 0.03), multiple organ failure (p = 0.14), and mortality (p = 0.13) were further reduced in this group. Authors believe that combination of early enteral nutrition and a selective, adequate antibiotic therapy may give a chance for prevention of multiple organ failure.
Oláh
A
A
Petz Aladár Megyei Kórház, Sebészeti Osztály
Pardavi
G
G
Belágyi
T
T
D000208:Acute Disease; D000328:Adult; D004750:Enteral Nutrition / Q000379:methods; D005260:Female; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D010195:Pancreatitis / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D010288:Parenteral Nutrition; D011446:Prospective Studies; D018805:Sepsis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D012720:Severity of Illness Index; D016019:Survival Analysis; D013845:Thienamycins / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
D013845:Thienamycins; D015378:Imipenem