Nutritional management of patients with acute pancreatitis: a Dutch observational multicentre study.
BACKGROUND
Following a nil per os (NPO) regimen, most patients with acute pancreatitis (AP) can resume normal oral intake within 1 week. If not tolerated, it is recommended to initiate artificial feeding, preferably by the enteral route.


OBJECTIVE
To evaluate the nutritional management of patients with AP in a Dutch cohort (EARL study).


METHODS
Observational study in 18 hospitals. Total days of NPO, tube feeding (TF) with/without oral feeding, total parenteral nutrition (TPN) and total starvation time were analysed.


RESULTS
In mild AP, a majority of cases (80.7%, 117/145) were managed with an NPO regimen only. Twenty-seven patients (18.6%) with mild AP additionally received TF; one received TPN. Of those with severe AP, more than half of the patients (56.2%, nine of 16) were treated with TF besides an NPO regimen; four received TPN. TF was delivered preferably via the jejunal route. The median period of total starvation was 2 days for both mild and severe AP. Only 5.5% (nine of 164) of patients had a prolonged starvation time of more than 5 days.


CONCLUSIONS
The total time of starvation was limited in a majority of patients admitted for AP. According to international guidelines, additional nutritional interventions were quickly undertaken with enteral feeding via the jejunum as the preferred route.
Spanier
B W M
BW
Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands. marcelspanier@xs4all.nl
Mathus-Vliegen
E M H
EM
Tuynman
H A R E
HA
Van der Hulst
R W M
RW
Dijkgraaf
M G W
MG
Bruno
M J
MJ
D000208:Acute Disease; D015331:Cohort Studies; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D009426:Netherlands; D010195:Pancreatitis / Q000628:therapy*; D010288:Parenteral Nutrition / Q000379:methods*; D011446:Prospective Studies; D013217:Starvation; D013997:Time Factors; D016896:Treatment Outcome