Total enteral nutrition in prevention of pancreatic necrotic infection in severe acute pancreatitis.
OBJECTIVE
This study was designed to evaluate the effects of total enteral nutrition and total parenteral nutrition in prevention of pancreatic necrotic infection in severe acute pancreatitis.


METHODS
One hundred seven patients were enrolled in the study between 2003 and 2007. In the first week of hospitalization, they were randomized to feeding by either total parenteral nutrition (54 patients) or total enteral nutrition (53 patients). All patients were concomitantly administered with sufficient prophylactic antibiotics. Computed tomographic scan and C-reactive protein level indicated a similar clinical severity in both groups.


RESULTS
Eighty percent of the patients developed organ failure in the group with total parenteral nutrition, which was higher than that in the group with total enteral nutrition (21%). Eighty percent and 22% (P < 0.05) of the patients in the total parenteral nutrition and total enteral nutrition groups, respectively, underwent surgical intervention. The incidence of pancreatic septic necroses in the group with total enteral nutrition (23%) was lower than that in the group with total parenteral nutrition (72%, P < 0.05). Mortality in the total parenteral nutrition group (43%) was higher than in the total enteral nutrition group (11%, P < 0.05).


CONCLUSIONS
Total enteral nutrition is better than total parenteral nutrition in the prevention of pancreatic necrotic infection in severe acute pancreatitis.
Wu
Xing-Mao
XM
Intensive Care Unit, Shengjing Hospital, China Medical University, Shenyang, Liaoning Province, China. wuxingmao@sohu.com
Ji
Kai-Qiang
KQ
Wang
Hai-Yuan
HY
Li
Guo-Fu
GF
Zang
Bin
B
Chen
Wei-Min
WM
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000382:microbiology / Q000401:mortality / Q000473:pathology / Q000517:prevention & control*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016009:Chi-Square Distribution; D004750:Enteral Nutrition / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000382:microbiology / Q000517:prevention & control; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D010289:Parenteral Nutrition, Total / Q000009:adverse effects / Q000401:mortality; D011015:Pneumonia, Aspiration / Q000382:microbiology / Q000517:prevention & control; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000382:microbiology / Q000517:prevention & control; D013997:Time Factors; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D015415:Biomarkers; D002097:C-Reactive Protein