title: A transatlantic survey of nutrition practice in acute pancreatitis.
abstract: BACKGROUND
  Many guidelines exist for the nutritional management of acute pancreatitis; however, little is known regarding current practice. We aimed to investigate feeding practices, including the use of parenteral/enteral nutrition.
  
  
  METHODS
  The study design was a cross-sectional, descriptive survey. Electronic surveys were sent to dietitians in the UK, the Republic of Ireland and Canada. Of 253 dietitians surveyed, 204 saw patients with acute pancreatitis regularly or occasionally and were included in the analyses.
  
  
  RESULTS
  Most dietitians (92.8%) considered early feeding to mean <48 h after presentation. Over half (54.2%) favoured early feeding in severe disease, less in obesity (42%) and more with pre-existing malnutrition (81.9%). There was a tendency to feed earlier in university hospitals (P = 0.015), especially in obesity (P = 0.011). There was a tendency towards enteral (versus parenteral) nutrition in university hospitals (P = 0.000). The majority preferred the jejunal route (64.2%), although this was lower in the UK (43.8%) than in Canada (77.8%) or Ireland (54.2%). Under one-quarter of UK dietitians (23.2%) reported the existence of a pancreatic multidisciplinary team in their institutions, although this was lower in Ireland and Canada.
  
  
  CONCLUSIONS
  Despite guidelines, there are gaps in the nutritional management of acute pancreatitis, including a continued reliance on parenteral feeding.
authors.affiliation: Department of Surgery, Trinity College Dublin, Dublin, Ireland. siduggan@tcd.ie
authors.forename: S N
authors.initials: SN
authors.lastname: Duggan
authors.forename: N D
authors.initials: ND
authors.lastname: Smyth
authors.forename: M
authors.initials: M
authors.lastname: O'Sullivan
authors.forename: S
authors.initials: S
authors.lastname: Feehan
authors.forename: P F
authors.initials: PF
authors.lastname: Ridgway
authors.forename: K C
authors.initials: KC
authors.lastname: Conlon
mesh_terms: D000208:Acute Disease; D002170:Canada; D003430:Cross-Sectional Studies; D004046:Dietetics; D004750:Enteral Nutrition / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006761:Hospitals; D006801:Humans; D007494:Ireland; D044342:Malnutrition / Q000150:complications; D018529:Nutritional Support / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data*; D009765:Obesity / Q000150:complications; D010195:Pancreatitis / Q000150:complications / Q000628:therapy*; D010288:Parenteral Nutrition / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D006113:United Kingdom