[Nutritional therapy in acute pancreatitis: a practical guide for the initial enteral nutritional support.].
BACKGROUND
Nutritional support is a cornerstone in acute pancreatitis (AP) treatment, which is a catabolic state that can result in patient's nutritional depletion. First step in the management of AP is to asses its severity. Despite mild AP cases usually do not require nutritional support severe cases benefit from its early initiation. Total enteral nutrition (TEN) decreases the frequency of complications and is the preferred nutrition modality in AP. Availability of nutrition specialists is often limited and usually the primary care physician decides when and how to start nutritional support in AP.


OBJECTIVE
To perform a systematic review about nutritional support in AP and create a TEN guide to aid the non nutrition specialist involved in the treatment of AP patients.


METHODS
The search for eligible studies was carried out using the Pub Med and the National Library of Medicine electronic data bases. Controlled clinical trials, treatment guidelines and systematic review articles were selected.


RESULTS
It is recommended to initiate nutritional support in AP cases that will be without oral intake longer than a week and TEN is the election modality. We created a TEN guide explaining how to choose and initiate TEN in AP.


CONCLUSIONS
Early TEN improves AP prognosis and is the nutritional modality of choice in every AP patients that will remain without oral intake longer than a week.
Gutiérrez-Salmeán
G
G
Escuela Superior de Medicina, Instituto Politécnico Nacional. México, D. F.
Peláez-Luna
M
M
D000208:Acute Disease; D003663:Decision Trees; D004750:Enteral Nutrition / Q000592:standards*; D006801:Humans; D008433:Mathematics; D010195:Pancreatitis / Q000628:therapy*; D012720:Severity of Illness Index