[Parenteral nutrition in acute pancreatitis]

Abstract

Oral feedings should be withheld in all patients with acute pancreatitis. A mild form of acute alcoholic pancreatitis does not necessarily require the administration of a nasogastric tube and central venous catheter, which should, however, be administered in all patients with more severe disease, with an unknown pathogenesis, and with complications. In most of those patients a central venous catheter is not only required for parenteral nutrition, but also for control of fluid administration. Glucose is recommended as the primary energy source (7-12 mg/kg/min); amino acids should be given at a calories (kcal/kg) to nitrogen (g/kg) ratio of 135:1. Fat is not recommended as the primary nonprotein energy source initially in the course of pancreatitis. Frequent serum controls of electrolytes and glucose are necessary to control electrolyte and insulin therapy. Calcium administration should be carried out with caution.