[Early jejunal feeding in acute pancreatitis: prevention of septic complications and multiorgan failure]

Magy Seb. 2000 Feb;53(1):7-12.
[Article in Hungarian]

Abstract

Authors evaluate the effect of early jejunal feeding on septic complications and mortality in acute pancreatitis, based on the results of a two-phase, prospective, randomized study. In the first part of the study they compared the conventional parenteral nutrition with early (started within 24 hours) enteral nutrition in a prospective, randomized trial on 89 patients. Forty-eight patients were randomized into the parenteral group "A" (Rindex 10, Infusamin S, Intralipid 10%: 30 kcal/kg) and 41 patients into the enteral group "B" (fed by nasogastric jejunal tube Survimed OPD, 30 kcal/kg). The rate of septic complications (infected necrosis, abscess, infected pseudocyst) were significantly lower in the enteral group (p = 0.08 chi-square test). In the second phase of the study early jejunal feeding was combined with imipenem prophylaxis (Tienam, 2 x 500 mg i.v.) in the necrotizing cases detected by CT scan. According to the results of 92 patients the rate of septic complications (p = 0.03), multiple organ failure (p = 0.14), and mortality (p = 0.13) were further reduced in this group. Authors believe that combination of early enteral nutrition and a selective, adequate antibiotic therapy may give a chance for prevention of multiple organ failure.

Publication types

  • Clinical Trial
  • English Abstract
  • Randomized Controlled Trial

MeSH terms

  • Acute Disease
  • Adult
  • Enteral Nutrition* / methods
  • Female
  • Humans
  • Imipenem / therapeutic use
  • Jejunostomy*
  • Male
  • Middle Aged
  • Multiple Organ Failure / etiology
  • Multiple Organ Failure / mortality
  • Multiple Organ Failure / prevention & control*
  • Pancreatitis / complications
  • Pancreatitis / mortality*
  • Pancreatitis / therapy*
  • Parenteral Nutrition
  • Prospective Studies
  • Sepsis / etiology
  • Sepsis / mortality
  • Sepsis / prevention & control*
  • Severity of Illness Index
  • Survival Analysis
  • Thienamycins / therapeutic use
  • Time Factors
  • Treatment Outcome

Substances

  • Thienamycins
  • Imipenem