title: [Total enteral nutrition vs. total parenteral nutrition in patients with severe acute pancreatitis].
abstract: OBJECTIVE
  To compare the efficacy of early total enteral nutrition (TEN) vs. total parenteral nutrition (TPN) in patients with severe acute pancreatitis (SAP).
  
  
  METHODS
  A total of 22 consecutive patients with SAP were randomized to receive TPN (group I) or TEN (group II). SAP was defined applying APACHE II score, C-reactive protein (CRP) measurements and/or Balthazar CT scan score. Acute inflammatory response (CRP, TNF-a, IL-6), visceral proteins (pre-albumin, albumin), complications (systemic inflammatory response syndrome, multiorgan failure, infections), surgical interventions, length of hospital stay and mortality were evaluated.
  
  
  RESULTS
  No significant differences were found between the two groups in the APACHE II score, in CRP, TNF-a and IL-6 concentrations or in pre-albumin and albumin levels over the first 10 days. Seven patients in group I and 4 in group II suffered severe complications. Three patients in group I required surgical intervention. Length of hospital stay was alike in the two groups. Two patients from group I died in the course of the hospitalization.
  
  
  CONCLUSIONS
  SAP patients with TEN feeding showed a tendency towards a better outcome than patients receiving TPN.
authors.affiliation: Servicios de Patología Digestiva, Hospital de la Santa Creu i Sant Pau, Barcelona.
authors.forename: M
authors.initials: M
authors.lastname: Casas
authors.forename: J
authors.initials: J
authors.lastname: Mora
authors.forename: E
authors.initials: E
authors.lastname: Fort
authors.forename: C
authors.initials: C
authors.lastname: Aracil
authors.forename: D
authors.initials: D
authors.lastname: Busquets
authors.forename: S
authors.initials: S
authors.lastname: Galter
authors.forename: C E
authors.initials: CE
authors.lastname: Jáuregui
authors.forename: E
authors.initials: E
authors.lastname: Ayala
authors.forename: D
authors.initials: D
authors.lastname: Cardona
authors.forename: I
authors.initials: I
authors.lastname: Gich
authors.forename: A
authors.initials: A
authors.lastname: Farré
mesh_terms: D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000368:Aged; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000628:therapy*; D010289:Parenteral Nutrition, Total