title: Enteral nutrition within 72 h after onset of acute pancreatitis vs delayed initiation.
abstract: OBJECTIVE
  To explore early (within 72 h) vs delayed enteral nutrition (EN) therapy for patients with acute pancreatitis (AP).
  
  
  METHODS
  A total of 93 patients were allocated to two groups: early enteral nutrition (EEN) group (started within 72 h after onset) and delayed enteral nutrition (DEN) group (started beyond 72 h but within 7 days after onset). Baseline parameters and scores were recorded on admission and on day 3 after the initiation of EN therapy, as were the clinical outcome variables.
  
  
  RESULTS
  Hospital mortality, length of stay, number of patients requiring mechanical ventilation and incidence of pancreatic infection in the EEN group were significantly lower than those in the DEN group; all six reported deaths were in the DEN group. In the DEN group, more patients suffered from sepsis, shock or acute kidney injury, and more patients required surgical intervention or continuous renal replacement therapy. On day 3 after EN therapy was initiated, the acute physiology and chronic health evaluation II scores, sequential organ failure assessment scores, C-reactive protein levels and the incidence of bowel wall thickening were lower in the EEN group than in the DEN group. The time when EN therapy was initiated was a prognostic variable for pancreatic infection (odds ratio, 24.08; P=0.014).
  
  
  CONCLUSIONS
  Compared with the DEN therapy, EEN therapy can accelerate the recovery of disturbed homeostasis, reduce the incidence of pancreatic infection and improve the clinical outcomes of AP patients. For AP patients, EN therapy should be initiated within 72 h after onset.
authors.affiliation: Department of General Surgery, Jinling Hospital, Nanjing University School of Medicine, No. 305 East Zhongshan Road, Nanjing, People's Republic of China.
authors.forename: L
authors.initials: L
authors.lastname: Zou
authors.affiliation: Department of General Surgery, Jinling Hospital, Nanjing University School of Medicine, No. 305 East Zhongshan Road, Nanjing, People's Republic of China.
authors.forename: L
authors.initials: L
authors.lastname: Ke
authors.affiliation: Department of General Surgery, Jinling Hospital, Nanjing University School of Medicine, No. 305 East Zhongshan Road, Nanjing, People's Republic of China.
authors.forename: W
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of General Surgery, Jinling Hospital, Nanjing University School of Medicine, No. 305 East Zhongshan Road, Nanjing, People's Republic of China.
authors.forename: Z
authors.initials: Z
authors.lastname: Tong
authors.affiliation: Department of General Surgery, Jinling Hospital, Nanjing University School of Medicine, No. 305 East Zhongshan Road, Nanjing, People's Republic of China.
authors.forename: C
authors.initials: C
authors.lastname: Wu
authors.affiliation: Department of General Surgery, Jinling Hospital, Nanjing University School of Medicine, No. 305 East Zhongshan Road, Nanjing, People's Republic of China.
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of General Surgery, Jinling Hospital, Nanjing University School of Medicine, No. 305 East Zhongshan Road, Nanjing, People's Republic of China.
authors.forename: G
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of General Surgery, Jinling Hospital, Nanjing University School of Medicine, No. 305 East Zhongshan Road, Nanjing, People's Republic of China.
authors.forename: N
authors.initials: N
authors.lastname: Li
authors.affiliation: Department of General Surgery, Jinling Hospital, Nanjing University School of Medicine, No. 305 East Zhongshan Road, Nanjing, People's Republic of China.
authors.forename: J
authors.initials: J
authors.lastname: Li
mesh_terms: D018806:APACHE; D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D004750:Enteral Nutrition / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000628:therapy*; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D012709:Serum Albumin; D002097:C-Reactive Protein