title: Association between probiotics and enteral nutrition in an experimental acute pancreatitis model in rats.
abstract: OBJECTIVE
  Recently, a randomized controlled trial showed that probiotic prophylaxis was associated with an increased mortality in enterally fed patients with predicted severe pancreatitis. In a rat model for acute pancreatitis, we investigated whether an association between probiotic prophylaxis and enteral nutrition contributed to the higher mortality rate.
  
  
  METHODS
  Male Sprague-Dawley rats were allocated to four groups: 1) acute pancreatitis (n = 9), 2) acute pancreatitis and probiotic prophylaxis (n = 10), 3) acute pancreatitis and enteral nutrition (n = 10), and 4) acute pancreatitis, probiotic prophylaxis and enteral nutrition (n = 11). Acute pancreatitis was induced by intraductal glycodeoxycholate and intravenous cerulein infusion. Enteral nutrition, saline, probiotics and placebo were administered through a permanent jejunal feeding. Probiotics or placebo were administered starting 4 days before induction of pancreatitis and enteral nutrition 1 day before start until the end of the experiment, 6 days after induction of pancreatitis. Tissue samples and body fluids were collected for microbiological and histological examination.
  
  
  RESULTS
  In all animals, serum amylase was increased six hours after induction of pancreatitis. After fulfilling the experiment, no differences between groups were found in histological severity of pancreatitis, degree of discomfort, weight loss, histological examination of small bowel and bacterial translocation (all p > 0.05). Overall mortality was 10% without differences between groups (p = 0.54).
  
  
  CONCLUSIONS
  No negative association was found between prophylactic probiotics and enteral nutrition in acute pancreatitis. No new clues for a potential mechanism responsible for the higher mortality and bowel ischaemia in the PROPATRIA study were found.
authors.affiliation: Dept. Operating Rooms/Evidence Based Surgery, Radboudumc, Nijmegen, The Netherlands. Electronic address: markvanbaal@gmail.com.
authors.forename: Mark C
authors.initials: MC
authors.lastname: van Baal
authors.affiliation: Dept. Operating Rooms/Evidence Based Surgery, Radboudumc, Nijmegen, The Netherlands.
authors.forename: Michiel J
authors.initials: MJ
authors.lastname: van Rens
authors.affiliation: Dept. Operating Rooms/Evidence Based Surgery, Radboudumc, Nijmegen, The Netherlands.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Geven
authors.affiliation: Dept. of Anesthesiology, Radboudumc, Nijmegen, The Netherlands.
authors.forename: Francien M
authors.initials: FM
authors.lastname: van de Pol
authors.affiliation: Dept. of Anesthesiology, Radboudumc, Nijmegen, The Netherlands.
authors.forename: Ilona W
authors.initials: IW
authors.lastname: van den Brink
authors.affiliation: Dept. Operating Rooms/Evidence Based Surgery, Radboudumc, Nijmegen, The Netherlands.
authors.forename: Gerjon
authors.initials: G
authors.lastname: Hannink
authors.affiliation: Dept. of Pathology, Radboudumc, Nijmegen, The Netherlands.
authors.forename: Iris D
authors.initials: ID
authors.lastname: Nagtegaal
authors.affiliation: Dept. of Gastroenterology, Radboudumc, Nijmegen, The Netherlands.
authors.forename: Wilbert H
authors.initials: WH
authors.lastname: Peters
authors.affiliation: Dept. Operating Rooms/Evidence Based Surgery, Radboudumc, Nijmegen, The Netherlands.
authors.forename: Ger T
authors.initials: GT
authors.lastname: Rijkers
authors.affiliation: Dept. Operating Rooms/Evidence Based Surgery, Radboudumc, Nijmegen, The Netherlands. Electronic address: hein.gooszen@radboudumc.nl.
authors.forename: Hein G
authors.initials: HG
authors.lastname: Gooszen
mesh_terms: D000681:Amylases / Q000097:blood; D000818:Animals; D001424:Bacterial Infections / Q000209:etiology / Q000473:pathology; D018988:Bacterial Translocation; D004750:Enteral Nutrition / Q000009:adverse effects* / Q000379:methods*; D005767:Gastrointestinal Diseases / Q000209:etiology; D007082:Ileum / Q000473:pathology; D007511:Ischemia; D007583:Jejunum / Q000473:pathology; D008297:Male; D010146:Pain / Q000209:etiology; D010179:Pancreas / Q000473:pathology; D010195:Pancreatitis / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D019936:Probiotics / Q000009:adverse effects* / Q000627:therapeutic use*; D051381:Rats; D017207:Rats, Sprague-Dawley
chemical_list: D000681:Amylases
keywords: Acute pancreatitis; Bacterial translocation; Bowel ischaemia; Enteral nutrition; Probiotics; Prophylaxis