Research progress in nutritional support therapy for severe acute pancreatitis

doi:10.3877/cma.j.issn.1674-0793.2023.05.014

Abstract

Abstract:

Severe acute pancreatitis (SAP) leads to numerous inflammatory and nutritional disturbances. All SAP patients are at a high nutritional risk. It has been proved that proper nutrition significantly reduces mortality rate and the incidence of infectious complications in SAP patients. Early (started within 24-48 h) enteral nutrition (EN) is optimal in most patients. EN protects gut barrier function because it decreases gastrointestinal dysmotility secondary to pancreatic inflammation. Currently, the application of parenteral nutrition (PN) in SAP is limited to those patients in whom EN is not possible or contraindicated. Early versus delayed EN, EN versus PN and the role of immunonutrition in SAP patients are discussed in this review.

Key words: Severe acute panceatitis, Nutritional support, Enteral nutrition, Parenteral nutrition, Immunonutrition, Glutamine

Cuijun Huang, Xiling Zhang, Sijia Liu, Yunjian Liu. Research progress in nutritional support therapy for severe acute pancreatitis[J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(05): 385-390.

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References 31

[1]	Rijkers AP, van Eijck CH. Acute pancreatitis[J]. N Engl J Med, 2017, 376(6): 596-597.
[2]	Gomes CA, Di Saverio S, Sartelli M, et al. Severe acute pancreatitis: eight fundamental steps revised according to the 'PANCREAS’ acronym[J]. Ann R Coll Surg Engl, 2020, 102(8): 555-559.
[3]	Murphy AE, Codner PA. Acute pancreatitis: exploring nutrition implications[J]. Nutr Clin Pract, 2020, 35(5): 807-817.
[4]	Khaliq A, Dutta U, Kochhar R, et al. Management of acute pancreatitis: "PANCREAS" contains eight easy steps to remember the treatment[J]. JOP, 2010, 11(5): 492-493.
[5]	Kanthasamy KA, Akshintala Vs, Singh VK. Nutritional management of acute pancreatitis[J]. Gastroenterol Clin North Am, 2021, 50(1): 141-150.
[6]	Yi F, Ge L, Zhao J, et al. Meta-analysis: total parenteral nutrition versus total enteral nutrition in predicted severe acute pancreatitis[J]. Intern Med, 2012, 51(6): 523-530.
[7]	Cao Y，Xu Y，Lu T，et al. Meta-analysis of enteral nutrition versus total parenteral nutrition in patients with severe acute pancreatitis[J]. Ann Nutr Metab, 2008, 53(3-4): 268-275.
[8]	Weimann A, Felbinger TW. Gastrointestinal dysmotility in the critically ill: A role for nutrition[J]. Curr Opin Clin Nutr Metab Care, 2016, 19(5): 353-359.
[9]	Hongyin L, Zhu H, Tao W, et al. Abdominal paracentesis drainage improves tolerance of enteral nutrition in acute pancreatitis: A randomized controlled trial[J]. Scand J Gastroenterol, 2017, 52(4): 389-395.
[10]	Sun JK, Mu XW, Li WQ, et al. Effects of early enteral nutrition on immune function of severe acute pancreatitis patients[J]. World J Gastroenterol, 2013, 19(6): 917-922.
[11]	Song J, Zhong Y, Lu X, et al. Enteral nutrition provided within 48 h after admission in severe acute pancreatitis: A systematic review and meta-analysis[J]. Medicine(Baltimore), 2018, 97: e11871.
[12]	Li JY, Yu T, Chen GC, et al. Enteral nutrition within 48 h of admission improves clinical outcomes of acute pancreatitis by reducing complications: A meta-analysis[J]. PLoS One, 2013, 8: e64926.
[13]	McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)[J]. JPEN J Parenter Enteral Nutr, 2016, 40(2): 159-211.
[14]	Singh N, Sharma B, Sharma M, et al. Evaluation of early enteral feeding through nasogastric and nasojejunal tube in severe acute pancreatitis: A noninferiority randomized controlled trial[J]. Pancreas, 2012, 41(1): 153-159.
[15]	Nally DM, Kelly EG, Clarke M, et al. Nasogastric nutrition is efficacious in severe acute pancreatitis: A systematic review and meta-analysis[J]. Br J Nutr, 2014, 112(11): 1769-1778.
[16]	Petrov MS, Loveday BP, Pylypchuk RD, et al. Systematic review and meta-analysis of enteral nutrition formulations in acute pancreatitis[J]. Br J Surg, 2009, 96(11): 1243-1252.
[17]	Endo A, Shiraishi A, Fushimi K, et al. Comparative effectiveness of elemental formula in the early enteral nutrition management of acute pancreatitis: A retrospective cohort study[J]. Ann Intensive Care, 2018, 8(1): 69.
[18]	Zhang SY, Liang ZY, Yu WQ, et al. Early enteral nutrition with polymeric feeds was associated with chylous ascites in patients with severe acute pancreatitis[J]. Pancreas, 2014, 43(4): 553-558.
[19]	Liang XY, Wu XA, Tian Y, et al. Effects of early versus delayed feeding in patients with acute pancreatitis: A systematic review and meta-analysis[J]. J Clin Gastroenterol, 2023, doi: 10.1097/MCG.0000000000001886.
[20]	Jablońska B, Mrowiec S. The role of immunonutrition in patients undergoing pancreaticoduodenectomy[J]. Nutrients, 2020, 12(9): 2547.
[21]	Poropat G, Giljaca V, Hauser G, et al. Enteral nutrition formulations for acute pancreatitis[J]. Cochrane Database Syst Rev, 2015, (3): CD010605.
[22]	Jafari T, Feizi A, Askari G, et al. Parenteral immunonutrition in patients with acute pancreatitis: A systematic review and meta-analysis[J]. Clin Nutr, 2015, 34(1): 35-43.
[23]	Zhou J, Xue Y, Liu Y, et al. The effect of immunonutrition in patients with acute pancreatitis: A systematic review and meta-analysis[J]. J Hum Nutr Diet, 2021, 34(2): 429-439.
[24]	王迎芝, 张先进, 杨士彦. 益生菌结合早期肠内营养对重症急性胰腺炎患者营养状况、肠黏膜屏障功能及肠内营养耐受性的影响[J/CD]. 中华消化病与影像杂志(电子版), 2023, 13(1): 55-58.
[25]	Gou S, Yang Z, Liu T, et al. Use of probiotics in the treatment of severe acute pancreatitis: A systematic review and meta-analysis of randomized controlled trials[J]. Crit Care, 2014, 18(2): R57.
[26]	Besselink MG, van Santvoort HC, Buskens E, et al. Probiotic prophylaxis in predicted severe acute pancreatitis: A randomised, double-blind, placebo-controlled trial[J]. Lancet, 2008, 371(9613): 651-659.
[27]	Wang G, Wen J, Xu L, et al. Effect of enteral nutrition and ecoimmunonutrition on bacterial translocation and cytokine production in patients with severe acute pancreatitis[J]. J Surg Res, 2013, 183(2): 592-597.
[28]	Arvanitakis M, Ockenga J, Bezmarevic M, et al. ESPEN guideline on clinical nutrition in acute and chronic pancreatitis[J]. Clin Nutr, 2020, 9(3): 612-631.
[29]	Crockett SD, Wani S, Gardner TB, et al. American Gastroenterological Association Institute Guideline on initial management of acute pancreatitis[J]. Gastroenterology, 2018, 154(4): 1096-1101.
[30]	Wu LM, Sankaran SJ, Plank LD, et al. Meta-analysis of gut barrier dysfunction in patients with acute pancreatitis[J]. Br J Surg, 2014, 101(13): 1644-1656.
[31]	刘世洲, 姚佳柔, 莫绍剑, 等. 重症急性胰腺炎营养支持研究进展[J/CD]. 中华肝脏外科手术学电子杂志, 2021, 10(5): 533-535.

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