When to initialize enteral nutrition in patients with severe acute pancreatitis? A retrospective review in a single institution experience (2003-2013).
OBJECTIVE
The present retrospective study aimed to analyze the optimal time to initiate enteral nutrition (EN) in patients with severe acute pancreatitis at a single Chinese institution (China Medical University Hospital).


METHODS
A total of 1196 patients with severe acute pancreatitis were admitted in the intensive care unit between November 2003 and June 2013; 1092 patients were selected and were divided into the early and delayed EN groups, according to their initial timing of EN.


RESULTS
Five hundred sixty-six patients were administered with the delayed EN, and 526 with the early EN. Both groups had similar severity of pancreatic necrosis, but organ failure developed in 81% patients of the delayed EN group and 21% in the early EN group (P < 0.01). The numbers of septic necrosis and morbidity were significantly higher in the delayed EN group than in the early EN (P < 0.01).


CONCLUSIONS
The early EN had significant benefits over the delayed EN in the decrease of organ failure and mortality; our findings suggested that the first 48 hours of administration in the intensive care unit was the optimal time to start EN.
From the Intensive Care Unit, Shengjing Hospital, China Medical University, Shenyang, Liaoning, China.
Xing-Mao
XM
Wu
Yu-Wei
YW
Liao
Hai-Yuan
HY
Wang
Kai-Qiang
KQ
Ji
Guo-Fu
GF
Li
Bin
B
Zang
D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China; D004750:Enteral Nutrition / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D010865:Pilot Projects; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology / Q000401:mortality; D012720:Severity of Illness Index; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D055815:Young Adult