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. 2007 Oct 21;13(39):5253-60.
doi: 10.3748/wjg.v13.i39.5253.

Early nasogastric enteral nutrition for severe acute pancreatitis: a systematic review

Kun Jiang  1 , Xin-Zu Chen, Qing Xia, Wen-Fu Tang, Lei Wang
Affiliations

Early nasogastric enteral nutrition for severe acute pancreatitis: a systematic review

Kun Jiang et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the effectiveness and safety of early nasogastric enteral nutrition (NGEN) for patients with severe acute pancreatitis (SAP).

Methods: We searched Cochrane Central Register of Controlled Trials (Issue 2, 2006), Pub-Medline (1966-2006), and references from relevant articles. We included randomized controlled trials (RCTs) only, which reported the mortality of SAP patients at least. Two reviewers assessed the quality of each trial and collected data independently. The Cochrane Collaboration's RevMan 4.2.9 software was used for statistical analysis.

Results: Three RCTs were included, involving 131 patients. The baselines of each trial were comparable. Meta-analysis showed no significant differences in mortality rate of SAP patients between nasogastric and conventional routes (RR = 0.76, 95% CI = 0.37 and 1.55, P = 0.45), and in other outcomes, including time of hospital stay (weighted mean difference = -5.87, 95% CI = -20.58 and 8.84, P = 0.43), complication rate of infection (RR = 1.41, 95% CI = 0.62 and 3.23, P = 0.41) or multiple organ deficiency syndrome (RR = 0.97, 95% CI = 0.27 and 3.47, P = 0.97), rate of admission to ICU (RR = 1.00, 95% CI = 0.48 and 2.09, P = 0.99) or conversion to surgery (RR = 0.66, 95% CI = 0.12 and 3.69, P = 0.64), as well as recurrence of re-feeding pain and adverse events associated with nutrition.

Conclusion: Early NGEN is a breakthrough in the management of SAP. Based on current studies, early NGEN appears effective and safe. Since the available evidence is poor in quantity, it is hard to make an accurate evaluation of the role of early NGEN in SAP. Before recommendation to clinical practice, further high qualified, large scale, randomized controlled trials are needed.

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Figures

Figure 1
Figure 1
Comparison of overall mortality between nasogastric enteral nutrition and conventional nutritional routes. Abbreviations: AP, acute pancreatitis; SAP, severe acute pancreatitis; EN, enteral nutrition; TPN, total parenteral nutrition; NGEN, nasogastric enteral nutrition; NJEN, nasojejunal enteral nutrition; RR, risk ratio; CI, confidence interval.
Figure 2
Figure 2
Comparison of total hospital stay (days) between nasogastric and nasojejunal enteral nutrition. WMD, weighted mean difference; SD, standard deviation.
Figure 3
Figure 3
Comparison of complications of acute pancreatitis between nasogastric enteral nutrition and conventional nutritional routes. MODS, multiple organ deficiency syndrome.
Figure 4
Figure 4
Comparison of management of complications between nasogastric enteral nutrition and conventional nutritional routes. ICU, intensive care unit.
Figure 5
Figure 5
Comparison of refeeding pain recurrence between nasogastric enteral nutrition and conventional nutritional routes.
Figure 6
Figure 6
Comparison of nutrition associated adverse events between nasogastric and nasojejunal enteral nutrition (NJEN).
See this image and copyright information in PMC

References

    1. Jiang K, Chen XZ, Xia Q, Tang WF, Wang L. Early veno-venous hemofiltration for severe acute pancreatitis: a systematic review. Zhongguo Xunzheng Yixue Zazhi. 2007;7:121–134.
    1. McClave SA, Greene LM, Snider HL, Makk LJ, Cheadle WG, Owens NA, Dukes LG, Goldsmith LJ. Comparison of the safety of early enteral vs parenteral nutrition in mild acute pancreatitis. JPEN J Parenter Enteral Nutr. 1997;21:14–20. - PubMed
    1. Abou-Assi S, O'Keefe SJ. Nutrition in acute pancreatitis. J Clin Gastroenterol. 2001;32:203–209. - PubMed
    1. Meier R, Beglinger C, Layer P, Gullo L, Keim V, Laugier R, Friess H, Schweitzer M, Macfie J. ESPEN guidelines on nutrition in acute pancreatitis. European Society of Parenteral and Enteral Nutrition. Clin Nutr. 2002;21:173–183. - PubMed
    1. Banks PA. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 1997;92:377–386. - PubMed

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