Hi Team,
We
recently discussed approach to Acute Pancreatitis.
One point
that I thought was interesting to discuss a bit further is the role of
nutrition in patients that have a prolonged course of complicated pancreatitis
(i.e. those in the ICU).
For those
who have a normal course of acute pancreatitis, we keep them NPO initially to
provide bowel rest and subsequently advance the diet in a few days once the
nausea, vomiting and pain have settled. We typically would start a clear fluid
diet at that point and advance as tolerated.
In
patients with prolonged and protracted courses of pancreatitis, consideration
of nasogastric (NG) or nasojejunal (NJ) tube feeds should be considered.
There is
evidence that enteral feeding in this group of patients can be beneficial (more
so than parenteral feeds) with respect to lowering the rate of hospital acquired
infections, decreasing the incidence of surgical intervention and reducing the
length of hospital stay. There may be a theoretical benefit to NJ versus NG
feeds, as NJ feeds bypass the need for pancreatic secretion.
Article: "Meta-analysis of parenteral nutrition versus enteral nutrition in patients with acute pancreatitis", Marik, P.E. et al, BMJ 2004
No comments:
Post a Comment