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Original Article

J. Islam. Int. Med. Coll.. 2013; 8(1): 3-9


Early Nasogastric Enteral Nutrition in Acute Pancreatitis

Ahmed Nurus Sami, Naseer Khan, Hamid Rasheed Goreja.

Abstract
Objective: To evaluate the effectiveness and safety of early Nasogastric Enteral Nutrition in patients with Acute Pancreatitis
Study Design: Randomized controlled trial.
Place and Duration of Study: The study was conducted at IIMC Hospital Islamabad, and Railways Hospital Rawalpindi from June 2008 to April 2011.
Materials and Methods: A total of 26 patients were studied over the course of 34 months who were admitted with the diagnosis of acute pancreatitis. Patients were divided randomly in two equal groups by consecutive sampling method. One group was given enteral nutrition (EN) through nasogastric tube beginning within 24 hours of admission (group-I), and the other group was provided nutrition through parenteral route (PN) only (Group-II). Outcome in the two groups such as length of hospital and ICU stay, infective complications, nutrition related complications, metabolic and catheter related complications were compared.
Results: Baseline of the study regarding infective complications and mortality were comparable. Average hospital stay was shorter by 22.3% in enterally fed group. ICU stay was also shorter in group-I patients. Significant difference was seen in relief of abdominal pain amongst the two groups, enterally fed (group-I) patients had earlier relief of pain starting on the 3rd day, compared to 5th day in group-II. Majority of the patients in group-I (84.5%) had pain relief between 4th and 9th day, while in group-II, 76.8% had pain relief between 7th and 12th day. Mean pain relief in enterally fed patients was in 7.5 days and in parenteral nutrition group in 10.2 days.
Nutrition related complication of diarrhoea was noted in 2 enterally fed patients. Metabolic complications (hyperglycaemia), and catheter related septic complications were seen only in parenterally fed patients. Acute pseudocyst formation occurred in one patient of enterally fed group as noted on follow up.
Conclusion: Early enteral nutrition is safe and effective in the management of acute pancreatitis. Enterally fed patients show advantage of shorter hospital and ICU stay, and earlier relief of symptoms compared to patients managed on parenteral nutrition. Our study considers early enteral nutrition feasible and desirable.

Key words: Acute pancreatitis, Early enteral nutrition, Total parental nutrition.






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The articles in Bibliomed are open access articles licensed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (https://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.