Nutritional management of patients with acute pancreatitis: a Dutch observational multicentre study

• Published in: Alimentary pharmacology & therapeutics Vol. 28; no. 9; pp. 1159 - 1165
• Main Authors: SPANIER, B. W. M., MATHUS‐VLIEGEN, E. M. H., TUYNMAN, H. A. R. E., VAN DER HULST, R. W. M., DIJKGRAAF, M. G. W., BRUNO, M. J.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.11.2008; Blackwell
• Subjects: Acute Disease; Biological and medical sciences; Cohort Studies; Digestive system; Enteral Nutrition - methods; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Length of Stay; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Netherlands; Other diseases. Semiology; Pancreatitis - therapy; Parenteral Nutrition - methods; Pharmacology. Drug treatments; Prospective Studies; Starvation; Time Factors; Treatment Outcome; Netherlands; Europe; Human; Clinical management; Acute; Multicenter study; Pancreatitis; Digestive diseases; Pancreatic disease
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2008.03814.x

Summary Background  Following a nil per os (NPO) regimen, most patients with acute pancreatitis (AP) can resume normal oral intake within 1 week. If not tolerated, it is recommended to initiate artificial feeding, preferably by the enteral route. Aim  To evaluate the nutritional management of patients with AP in a Dutch cohort (EARL study). Methods  Observational study in 18 hospitals. Total days of NPO, tube feeding (TF) with/without oral feeding, total parenteral nutrition (TPN) and total starvation time were analysed. Results  In mild AP, a majority of cases (80.7%, 117/145) were managed with an NPO regimen only. Twenty‐seven patients (18.6%) with mild AP additionally received TF; one received TPN. Of those with severe AP, more than half of the patients (56.2%, nine of 16) were treated with TF besides an NPO regimen; four received TPN. TF was delivered preferably via the jejunal route. The median period of total starvation was 2 days for both mild and severe AP. Only 5.5% (nine of 164) of patients had a prolonged starvation time of more than 5 days. Conclusions  The total time of starvation was limited in a majority of patients admitted for AP. According to international guidelines, additional nutritional interventions were quickly undertaken with enteral feeding via the jejunum as the preferred route.