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acute pancreatitis enteral nutrition

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...
October 3, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
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...
2016: BMC Gastroenterology
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
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
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
Jayshil J Patel, Martin D Rosenthal, Keith R Miller, Robert G Martindale
PURPOSE OF REVIEW: The purpose of this review is to describe established and emerging mechanisms of gut injury and dysfunction in trauma, describe emerging strategies to improve gut dysfunction, detail the effect of trauma on the gut microbiome, and describe the gut-brain connection in traumatic brain injury. RECENT FINDINGS: Newer data suggest intraluminal contents, pancreatic enzymes, and hepatobiliary factors disrupt the intestinal mucosal layer. These mechanisms serve to perpetuate the inflammatory response leading to multiple organ dysfunction syndrome (MODS)...
August 2016: Current Opinion in Critical Care
Lan Peng, Li-Guo Wu, Bo Li, Jun Zhao, Li-Ming Wen
PURPOSE: To investigate the role of early enteral nutrition (EEN) in the intestinal immune barrier in SAP, and to explore its potential mechanisms. METHODS: Sixty rats were randomly assigned to 3 groups: sham-operated group (SO group, n = 20), SAP group receiving EEN (SAP + EEN group, n = 20), and SAP group receiving total parental nutrition (SAP + TPN group, n = 20). SAP was induced by infusion of sodium taurocholate. Rats were sacrificed 5 days after nutritional support...
May 10, 2016: Journal of Hepato-biliary-pancreatic Sciences
D Stimac, G Poropat, G Hauser, V Licul, N Franjic, P Valkovic Zujic, S Milic
BACKGROUND/OBJECTIVES: There is substantial evidence of superiority of enteral nutrition (EN) to parenteral nutrition in acute pancreatitis (AP) treatment, but few studies evaluated its effectiveness compared to no intervention. The objective of our trial was to compare the effects of EN to a nil-by-mouth (NBM) regimen in patients with AP. METHODS: Patients with AP were randomized to receive either EN via a nasojejunal tube initiated within 24 h of admission or no nutritional support...
July 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Benoît Dupont, Marietta Musikas, Manh-Thông Dao, Marie-Astrid Piquet
No abstract text is available yet for this article.
May 2016: Pancreas
Amer Hawatmeh, Anas Alkhateeb, Ahmad Abu Arqoub, Khalid Jumean, Hamid Shaaban
The percutaneous endoscopic gastrostomy (PEG) tube is an important method of providing enteral nutrition to patients with swallowing disorders and those who need long-term enteral nutritional support. The association between PEG tube migration and acute pancreatitis is rare and was previously described in the literature. To the best of our knowledge, only 11 cases have been reported in the literature. In this article, we are describing two cases of acute pancreatitis secondary to PEG tube balloon migration to the duodenum...
January 2016: International Journal of Critical Illness and Injury Science
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
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
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
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
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
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
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
Maisam Abu-El-Haija, Rebecca Wilhelm, Christie Heinzman, Bruna Nabuco Freire Siqueira, Yuanshu Zou, Lin Fei, Conrad R Cole
Nutrition is an integral part of acute pancreatitis (AP) management and is not adequately studied in pediatrics. The goal from the present study was to evaluate the effect of nutrition and fat content on the length of stay and pain severity in patients with AP. This is a retrospective review of our nutrition database between May 1, 2014 and December 1, 2014. Pain levels were similar between patients who were allowed to feed and patients kept nill per os. Higher fat intake grams per kilogram per day was associated with significantly lower pain scores...
March 2016: Journal of Pediatric Gastroenterology and Nutrition
Jiemin Ma, Sayali A Pendharkar, Gregory O'Grady, John A Windsor, Maxim S Petrov
BACKGROUND: Evidence from animal studies suggests that gastrointestinal motility is impaired in acute pancreatitis. Enteral nutrition, and more specifically nasogastric tube feeding, has emerged as a key treatment modality in patients with acute pancreatitis, but its effect on motility has not been investigated in this setting. The aim was to validate the Gastroparesis Cardinal Symptom Index (GCSI) in patients with acute pancreatitis and determine the effect of nasogastric tube feeding on GCSI...
February 2016: Nutrition in Clinical Practice
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
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