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Enteral nutrition for acute pancreatitis

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https://www.readbyqxmd.com/read/27847836/obstructive-acute-pancreatitis-secondary-to-peg-tube-migration
#1
Douglas F Taylor, Ryan Cho, Allan Cho, Viet Nguyen, Abhijit Sunnapwar, Craig Womeldorph
Percutaneous gastrostomy is a well-established method of providing enteral nutrition to patients incapable of oral intake, or for whom oral intake is insufficient to meet metabolic needs. In comparison to total parenteral nutrition, enteral feeding is advantageous in that it helps maintain gut mucosal integrity, which decreases the risk of bacterial translocation through the gastrointestinal tract. Complications include bleeding, aspiration, internal organ injury, perforation, periostomal leaks, tube dislodgement, and occlusion...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27798670/prospective-multicentre-nationwide-clinical-data-from-600-cases-of-acute-pancreatitis
#2
Andrea Párniczky, Balázs Kui, Andrea Szentesi, Anita Balázs, Ákos Szűcs, Dóra Mosztbacher, József Czimmer, Patrícia Sarlós, Judit Bajor, Szilárd Gódi, Áron Vincze, Anita Illés, Imre Szabó, Gabriella Pár, Tamás Takács, László Czakó, Zoltán Szepes, Zoltán Rakonczay, Ferenc Izbéki, Judit Gervain, Adrienn Halász, János Novák, Stefan Crai, István Hritz, Csaba Góg, János Sümegi, Petra Golovics, Márta Varga, Barnabás Bod, József Hamvas, Mónika Varga-Müller, Zsuzsanna Papp, Miklós Sahin-Tóth, Péter Hegyi
OBJECTIVE: The aim of this study was to analyse the clinical characteristics of acute pancreatitis (AP) in a prospectively collected, large, multicentre cohort and to validate the major recommendations in the IAP/APA evidence-based guidelines for the management of AP. DESIGN: Eighty-six different clinical parameters were collected using an electronic clinical research form designed by the Hungarian Pancreatic Study Group. PATIENTS: 600 adult patients diagnosed with AP were prospectively enrolled from 17 Hungarian centres over a two-year period from 1 January 2013...
2016: PloS One
https://www.readbyqxmd.com/read/27775609/meta-analysis-of-early-nutrition-the-benefits-of-enteral-feeding-compared-to-a-nil-per-os-diet-not-only-in-severe-but-also-in-mild-and-moderate-acute-pancreatitis
#3
Katalin Márta, Nelli Farkas, Imre Szabó, Anita Illés, Áron Vincze, Gabriella Pár, Patrícia Sarlós, Judit Bajor, Ákos Szűcs, József Czimmer, Dóra Mosztbacher, Andrea Párniczky, Kata Szemes, Dániel Pécsi, Péter Hegyi
The recently published guidelines for acute pancreatitis (AP) suggest that enteral nutrition (EN) should be the primary therapy in patients suffering from severe acute pancreatitis (SAP); however, none of the guidelines have recommendations on mild and moderate AP (MAP). A meta-analysis was performed using the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P). The following PICO (problem, intervention, comparison, outcome) was applied: P: nutrition in AP; I: enteral nutrition (EN); C: nil per os diet (NPO); and O: outcome...
October 20, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27727096/predicting-the-clinical-manifestations-in-necrotizing-acute-pancreatitis-patients-with-splanchnic-vein-thrombosis
#4
Jing Zhou, Lu Ke, Dongliang Yang, Yizhe Chen, Gang Li, Zhihui Tong, Weiqin Li, Jieshou Li
BACKGROUND: Splanchnic venous thrombosis (SVT) is a relatively rare but important complication of necrotizing acute pancreatitis (NAP). Clinical manifestations and severity of this complication in different patients vary greatly, ranging from mild abdominal discomfort even asymptomatic to lethal gastrorrhagia or hepatic failure. The aim of the present study was to develop a model to predict the clinical manifestations of SVT in NAP patients. METHODS: This retrospective cohort study was conducted in the surgical intensive care unit (SICU) of Jinling Hospital...
November 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/27549125/the-clinical-value-of-adipokines-in-predicting-the-severity-and-outcome-of-acute-pancreatitis
#5
Andrius Karpavicius, Zilvinas Dambrauskas, Audrius Gradauskas, Arturas Samuilis, Kristina Zviniene, Juozas Kupcinskas, Gintautas Brimas, Artur Meckovski, Audrius Sileikis, Kestutis Strupas
BACKGROUND: Recent data shows that patients with severe acute pancreatic might benefit from early intensive therapy, enteral nutrition and timely transfer to specialized centers. The early prophylactic use of antibiotics in AP remains controversial. The role and need for new markers in stratification of acute pancreatitis is also uncertain. This study aims to evaluate the prognostic usefulness of adipokines in prediction of the severity and outcome of acute pancreatitis (AP). METHODS: Prospective study was conducted in four clinical centers...
August 22, 2016: BMC Gastroenterology
https://www.readbyqxmd.com/read/27498584/risk-factors-of-infected-pancreatic-necrosis-secondary-to-severe-acute-pancreatitis
#6
Liang Ji, Jia-Chen Lv, Zeng-Fu Song, Mai-Tao Jiang, Le Li, Bei Sun
BACKGROUND: Severe acute pancreatitis (SAP) remains a clinical challenge with considerable morbidity and mortality. An early identification of infected pancreatic necrosis (IPN), a life-threatening evolution secondary to SAP, is obliged for a more preferable prognosis. Thus, the present study was conducted to identify the risk factors of IPN secondary to SAP. METHODS: The clinical data of patients with SAP were retrospectively analyzed. Univariate and multivariate logistic regression analyses were sequentially performed to assess the associations between the variables and the development of IPN secondary to SAP...
August 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/27412739/-clinical-analysis-of-enteral-nutrition-in-47-children
#7
R D Zhuang, L J Tang, Y H Fang, K R Peng, J Chen
OBJECTIVE: To explore the efficacy and safety of the application of enteral nutrition (EN) in gastrointestinal disease in children, and to explore the possibility of the implementation of family EN. METHOD: Retrospective analysis of disease spectrum, EN approach, preparation, speed and time as well as adverse reactions and outcomes in 47 pediatric patients with gastrointestinal disease underwent EN therapy during July 2014 to March 2015. The nutrition indicators before and after EN therapy were compared by paired t-test...
July 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/27332898/decision-making-in-necrotizing-pancreatitis
#8
Thilo Hackert, Markus Wolfgang Büchler
The management of acute necrotizing pancreatitis (ANP) has undergone a change of paradigms during the last 2 decades with a decreasing impact of surgical interventions. Modern ANP management is done conservatively as long as possible and therapeutic approaches aim at volume resuscitation, pain management and early enteral nutrition. The diagnostic gold standard of contrast-enhanced CT scan helps to evaluate the extent of necrosis of the pancreas, which correlates with the risk of tissue infection. The crucial point for decision making is the proven existence of infected pancreatic necrosis...
2016: Digestive Diseases
https://www.readbyqxmd.com/read/26900288/management-of-pancreatic-fluid-collections-a-comprehensive-review-of-the-literature
#9
REVIEW
Amy Tyberg, Kunal Karia, Moamen Gabr, Amit Desai, Rushabh Doshi, Monica Gaidhane, Reem Z Sharaiha, Michel Kahaleh
Pancreatic fluid collections (PFCs) are a frequent complication of pancreatitis. It is important to classify PFCs to guide management. The revised Atlanta criteria classifies PFCs as acute or chronic, with chronic fluid collections subdivided into pseudocysts and walled-off pancreatic necrosis (WOPN). Establishing adequate nutritional support is an essential step in the management of PFCs. Early attempts at oral feeding can be trialed in patients with mild pancreatitis. Enteral feeding should be implemented in patients with moderate to severe pancreatitis...
February 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/26823272/nutrition-in-acute-pancreatitis-a-critical-review
#10
Piet J Lodewijkx, Marc G Besselink, Ben J Witteman, Nicolien J Schepers, Hein G Gooszen, Hjalmar C van Santvoort, Olaf J Bakker
Severe acute pancreatitis poses unique nutritional challenges. The optimal nutritional support in patients with severe acute pancreatitis has been a subject of debate for decades. This review provides a critical review of the available literature. According to current literature, enteral nutrition is superior to parenteral nutrition, although several limitations should be taken into account. The optimal route of enteral nutrition remains unclear, but normal or nasogastric tube feeding seems safe when tolerated...
2016: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/26812753/the-use-of-negative-pressure-wound-therapy-npwt-in-the-management-of-enteroatmospheric-fistula-case-report-and-literature-review
#11
Rajmund Jaguścik, Dominik A Walczak, Joanna Porzeżyńska, Piotr W Trzeciak
An enteric fistula that occurs in an open abdomen is called an enteroatmospheric fistula (EAF) and is the most challenging complication for a surgical team to deal with. The treatment of EAF requires a multidisciplinary approach. First of all, sepsis has to be managed. Any fluid, electrolyte and metabolic disorders need to be corrected. Oral intake must be stopped and total parenteral nutrition introduced. The control and drainage of the effluent from the fistula is a separate issue. Since there are no fixed algorithms for the treatment of EAF, surgeons need to develop their own, often highly unconventional solutions...
October 2015: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/26808264/is-early-starvation-beneficial-for-the-critically-ill-patient
#12
REVIEW
Paul E Marik
PURPOSE OF REVIEW: Anorexia is a preserved evolutionally response that may be beneficial during acute illness. Yet current clinical practice guidelines recommend early and targeted enteral nutritional support. However, the optimal timing of the initiation of enteral nutrition and the caloric and protein requirements of critically ill patients is controversial. RECENT FINDINGS: Starvation promotes autophagy and this may play a key role in promoting host defenses and the immune response to intracellular pathogens...
March 2016: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/26707037/a-case-of-acute-pancreatitis-secondary-to-spinal-cord-injury-case-report
#13
Lijun Cao, Yun Sun, Zhonghua Lu, Pinjie Zhang, Lu Yin, Hui Li, Tianfeng Hua, Yao Zheng
Acute pancreatitis (AP) is a frequent and potentially life-threatening disease with high morbidity and mortality. The overall mortality of AP is approximately 5%. Alcohol consumption and gallstones are the main etiology of AP. Hypertriglyceridemia, idiosyncratic reactions to drugs, anatomic alterations and ascaris lumbricoides can also give rise to AP. Although spinal cord injury (SCI) can cause AP, however, the case of induced by cervical spine surgery has not been reported. A 61-year-old man with quadriplegic and respiratory distress received cervical spine surgery for spinal cervical spondylosis and multi-stage longitudinal ligament...
2015: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/26621675/compliance-with-evidence-based-guidelines-in-acute-pancreatitis-an-audit-of-practices-in-university-of-toronto-hospitals
#14
J A Greenberg, J Hsu, M Bawazeer, J Marshall, J O Friedrich, A Nathens, N Coburn, H Huang, R S McLeod
Despite existing evidence-based practice guidelines for the management of acute pancreatitis, clinical compliance with recommendations is poor. We conducted a retrospective review of 248 patients admitted between 2010 and 2012 with acute pancreatitis at eight University of Toronto affiliated hospitals. We included all patients admitted to ICU (52) and 25 ward patients from each site (196). Management was compared with the most current evidence used in the Best Practice in General Surgery Management of Acute Pancreatitis Guideline...
February 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/26495124/the-effect-of-enteral-nutrition-on-adipokines-in-patients-with-acute-pancreatitis
#15
Sarah J L McKenzie, Rakesh Premkumar, Kathryn J Askelund, Sayali A Pendharkar, Anthony R J Phillips, John A Windsor, Maxim S Petrov
The mechanism behind the beneficial effects of enteral nutrition (EN) for patients with acute pancreatitis (AP) is largely unknown. Adipokines, as mediators of metabolism and inflammation, may be a possible mechanism. The study aimed to investigate the effect of EN on adipokines early in the course of AP. Patients with AP were randomised to EN or nil-by-mouth (NBM). Blood samples were taken on the first 4 d of admission and adipokine concentrations for adiponectin, leptin, omentin, resistin and visfatin were determined by ELISA assays...
2015: Journal of Nutritional Science
https://www.readbyqxmd.com/read/26309362/fluid-resuscitation-in-acute-pancreatitis-normal-saline-or-lactated-ringer-s-solution
#16
COMPARATIVE STUDY
Michal Lipinski, Alicja Rydzewska-Rosolowska, Andrzej Rydzewski, Grazyna Rydzewska
AIM: To investigate whether administration of Ringer's solution (RL) could have an impact on the outcome of acute pancreatitis (AP). METHODS: We conducted a retrospective study on 103 patients [68 men and 35 women, mean age 51.2 years (range, 19-92 years)] hospitalized between 2011 and 2012. All patients admitted to the Department of Gastroenterology of the Central Clinical Hospital of the Ministry of Interior (Poland) with a diagnosis of AP who had disease onset within 48 h of presentation were included in this study...
August 21, 2015: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/26306567/established-enteral-nutrition-pathway-in-a-severe-acute-pancreatitis-patient-with-duodenum-fistula-a-case-report
#17
G Li, X Shen, L Ke, Z Tong, W Li
Enteral feeding is the preferred way to provide nutritional support in patients with high nutritional risk but relatively normal gastrointestinal function; thus, establishing a safe and a reliable pathway of enteral nutrition (EN) is of great importance. There are many techniques for placing the feeding tube, such as blind placement at bedside, assisting by fluoroscopy and endoscopy, surgical and so on. Despite these variable techniques, it is still difficult to obtain the pathway for EN in some specific patients...
October 2015: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/26286761/antibiosis-of-necrotizing-pancreatitis
#18
REVIEW
Alexander Arlt, Wiebke Erhart, Clemens Schafmayer, Hanns-Christoph Held, Jochen Hampe
BACKGROUND: Necrotizing pancreatitis is a life-threatening presentation of acute pancreatitis. The mortality of 20-80% initially depends on the persistence of organ failure and systemic inflammatory response syndrome (SIRS) and, in the later course of the disease, on secondary infection of the necrosis. The questions whether prophylactic antibiotics aiming to prevent this infection should be administered and which antibiotic is the best to use, as well as the problem of fungal infection under antibiotic treatment are still intriguing and insufficiently solved...
October 2014: Viszeralmedizin
https://www.readbyqxmd.com/read/26214512/experience-in-bedside-placement-clinical-validity-and-cost-efficacy-of-a-self-propelled-nasojejunal-feeding-tube
#19
Carolina Puiggròs, Rosa Molinos, M Dolors Ortiz, Montserrat Ribas, Carlos Romero, Concepcion Vázquez, Hegoi Segurola, Rosa Burgos
BACKGROUND: The procedures needed to insert nasojejunal tubes (NJTs) are often invasive or uncomfortable for the patient and require hospital resources. The objectives of this study were to describe our experience in inserting a self-propelling NJT with distal pigtail end and evaluate clinical validity and cost efficacy of this enteral nutrition (EN) approach compared with parenteral nutrition (PN). MATERIALS AND METHODS: Prospective study from July 2009 to December 2010, including hospitalized noncritical patients who required short-term jejunal EN...
December 2015: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/26210842/early-enteral-nutrition-and-aggressive-fluid-resuscitation-are-associated-with-improved-clinical-outcomes-in-acute-pancreatitis
#20
Flora K Szabo, Lin Fei, Ligia Alfaro Cruz, Maisam Abu-El-Haija
OBJECTIVES: To determine whether recommendations for treatment of acute pancreatitis (AP) in adults impact the outcomes of pediatric AP. STUDY DESIGN: Adult guidelines regarding early management of AP were implemented through an admission order set at Cincinnati Children's Hospital Medical Center at the beginning of the year 2014. Recommendations included administering high rates of intravenous fluid (IVF) within 24 hours of admission and enteral nutrition within 48 hours of admission...
August 2015: Journal of Pediatrics
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