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Randomized Controlled Trial
. 2006 Jan-Feb;30(1):1-5.
doi: 10.1177/014860710603000101.

Semi-elemental formula or polymeric formula: is there a better choice for enteral nutrition in acute pancreatitis? Randomized comparative study

Laurent-Eric Tiengou  1 , Romain Gloro, Julien Pouzoulet, Karine Bouhier, Marie-Hélène Read, Franck Arnaud-Battandier, Jean-Marie Plaze, Xavier Blaizot, Thông Dao, Marie-Astrid Piquet
Affiliations
Randomized Controlled Trial

Semi-elemental formula or polymeric formula: is there a better choice for enteral nutrition in acute pancreatitis? Randomized comparative study

Laurent-Eric Tiengou et al. JPEN J Parenter Enteral Nutr. 2006 Jan-Feb.

Abstract

Background: Jejunal nutrition is recommended during acute pancreatitis. The use of semi-elemental formulas presents several theoretical advantages over polymeric formulas, but their clinical value has been poorly documented. Our aim was to evaluate in patients with acute pancreatitis the effect of enteral nutrition by a semi-elemental formula compared with a polymeric formula.

Methods: A randomized prospective pilot study, stratified according to severity, was performed in 30 consecutive patients with acute pancreatitis requiring jejunal nutrition. The semi-elemental group received 35 kcal/kg/d of Peptamen (n = 15), and the polymeric group received the same quantity of Sondalis-Iso (n = 15). Tolerance was evaluated after 7 days of enteral nutrition (D7) on visual analog scale (VAS), stool frequency, and 24-hour steatorrhea/creatorrhea. Outcome was evaluated by weight loss, length of hospital stay, and infection rate.

Results: Results were calculated as mean +/- SEM, t-test, or chi2. Patients of the 2 groups were comparable in terms of age, gender, and severity. Tolerance was good in both groups (semi-elemental vs polymeric: VAS, 7.4 +/- 0.6 vs 7.1 +/- 0.6, not significant (NS); number of stools per 24 hours, 1.7 +/- 0.4 vs 1.8 +/- 0.4, NS). Steatorrhea and creatorrhea were lower than normal in both groups. In semi-elemental group, the length of hospital stay was shorter (23 +/- 2 vs 27 +/- 1, p = .006) and weight loss was less marked (1 +/- 1 vs 2 +/- 0, p = .01). One patient in semi-elemental group and 3 patients in polymeric group developed an infection (NS).

Conclusions: Semi-elemental and polymeric nutrition are very well tolerated in patients with acute pancreatitis. Nutrition with a semi-elemental formula supports the hypothesis of a more favorable clinical course than nutrition with a polymeric formula, but this conclusion needs to be established in larger adequately powered clinical trials.

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Comment in

  • Beware of big gifts in small studies.
    Lipman TO. Lipman TO. JPEN J Parenter Enteral Nutr. 2006 Jan-Feb;30(1):66-8. doi: 10.1177/014860710603000166. JPEN J Parenter Enteral Nutr. 2006. PMID: 16387904 No abstract available.

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