Comparison of enteral and parenteral nutrition in the management of acute pancreatitis
DOI:
https://doi.org/10.56294/saludcyt2024.532Keywords:
enteral nutrition, acute pancreatitis, comparison, clinical outcomes, literature reviewAbstract
This study investigated the efficacy of enteral nutrition compared with parenteral nutrition in patients with acute pancreatitis, with the aim of determining which of these modalities provides better clinical outcomes. A qualitative analysis was performed based on the review of meta-analyses and literature reviews, using a search of recognised medical databases. Inclusion criteria included clinical trials, systematic reviews and relevant observational studies, and the methodological quality of the selected studies was assessed. The results highlighted that enteral nutrition was associated with a significant reduction in mortality, systemic infections, need for surgical interventions and length of hospital stay compared with parenteral nutrition. Meta-analyses indicated that enteral nutrition not only decreased serious complications, but also showed a trend towards an improvement in overall clinical outcomes. These results suggest that enteral nutrition is a preferred strategy for the management of acute pancreatitis, given its superiority in terms of reduced complications and hospital costs. This study highlights the importance of reconsidering parenteral nutrition in favor of options that optimize recovery and clinical resources
References
1. Pérez F, Valdes EA. Pancreatitis aguda: artículo de revisión. Rev Médico Científica [Internet]. 2020;33(1):67–88. Available from: https://revistamedicocientifica.org/index.php/rmc/article/view/570 DOI: https://doi.org/10.37416/rmc.v33i1.570
2. Jamanca Milian H, Cano Cardenas L. Factores pronósticos de severidad en pancreatitis aguda en un hospital peruano. Rev la Fac Med Humana [Internet]. 2020;20(1):14–9. Available from: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S2308-05312020000100014 DOI: https://doi.org/10.25176/RFMH.v20i1.2543
3. Mayerle J, Sendler M, Hegyi E, Beyer G, Lerch MM, Sahin-Tóth M. Genetics, cell biology, and pathophysiology of pancreatitis. Gastroenterology [Internet]. 2019;156(7):1951–68. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0016508519300496 DOI: https://doi.org/10.1053/j.gastro.2018.11.081
4. Szatmary P, Grammatikopoulos T, Cai W, Huang W, Mukherjee R, Halloran C, et al. Acute pancreatitis: diagnosis and treatment. Drugs [Internet]. 2022;82(12):1251–76. Available from: https://link.springer.com/article/10.1007/s40265-022-01766-4 DOI: https://doi.org/10.1007/s40265-022-01766-4
5. Beyer G, Habtezion A, Werner J, Lerch MM, Mayerle J. Chronic pancreatitis. Lancet [Internet]. 2020;396(10249):499–512. Available from: https://www.thelancet.com/article/S0140-6736(20)31318-0/abstract DOI: https://doi.org/10.1016/S0140-6736(20)31318-0
6. Singh VK, Yadav D, Garg PK. Diagnosis and management of chronic pancreatitis: a review. Jama [Internet]. 2019;322(24):2422–34. Available from: https://jamanetwork.com/journals/jama/article-abstract/2757821 DOI: https://doi.org/10.1001/jama.2019.19411
7. Delgado JE, Rodriguez D, Villalobos MS. La Pancreatitis Aguda: diagnóstico y manejo. Rev la Fac Med la Univ lberoamérica [Internet]. 2023;2(2):45–56. Available from: https://www.revista-portalesmedicos.com/revista-medica/pancreatitis-aguda-diagnostico-y-manejo/ DOI: https://doi.org/10.54376/rcmui.v2i2.164
8. Ramanathan M, Aadam AA. Nutrition management in acute pancreatitis. Nutr Clin Pract [Internet]. 2019;34:S7–12. Available from: https://aspenjournals.onlinelibrary.wiley.com/doi/full/10.1002/ncp.10386 DOI: https://doi.org/10.1002/ncp.10386
9. Cañamares-Orbís P, García-Rayado G, Alfaro-Almajano E. Nutritional support in pancreatic diseases. Nutrients [Internet]. 2022;14(21):4570. Available from: https://www.mdpi.com/2072-6643/14/21/4570 DOI: https://doi.org/10.3390/nu14214570
10. Storck LJ, Imoberdorf R, Ballmer PE. Nutrition in gastrointestinal disease: liver, pancreatic, and inflammatory bowel disease. J Clin Med [Internet]. 2019;8(8):1098. Available from: https://www.mdpi.com/2077-0383/8/8/1098 DOI: https://doi.org/10.3390/jcm8081098
11. Machicado JD, Wani S, Quingalahua E, Han S, Simon V, Hegyi P, et al. Practice patterns and adherence to nutrition guidelines in acute pancreatitis: An international physician survey. Pancreatology [Internet]. 2021;21(3):642–8. Available from: https://www.sciencedirect.com/science/article/abs/pii/S1424390321000259 DOI: https://doi.org/10.1016/j.pan.2021.01.001
12. Jabłońska B, Mrowiec S. Nutritional support in patients with severe acute pancreatitis-current standards. Nutrients [Internet]. 2021;13(5):1498. Available from: https://www.mdpi.com/2072-6643/13/5/1498 DOI: https://doi.org/10.3390/nu13051498
13. O’Brien SJ, Omer E. Chronic pancreatitis and nutrition therapy. Nutr Clin Pract [Internet]. 2019;34:S13–26. Available from: https://aspenjournals.onlinelibrary.wiley.com/doi/full/10.1002/ncp.10379 DOI: https://doi.org/10.1002/ncp.10379
14. Al‐Omran M, AlBalawi ZH, Tashkandi MF, Al‐Ansary LA. Enteral versus parenteral nutrition for acute pancreatitis. Cochrane database Syst Rev [Internet]. 2010;(1). Available from: https://www.sciencedirect.com/science/article/abs/pii/S0210570513700608 DOI: https://doi.org/10.1002/14651858.CD002837.pub2
15. Marik PE, Zaloga GP. Meta-analysis of parenteral nutrition versus enteral nutrition in patients with acute pancreatitis. BMJ [Internet]. 2004;328(7453):1407. Available from: https://www.bmj.com/content/328/7453/1407.full DOI: https://doi.org/10.1136/bmj.38118.593900.55
16. Petrov MS, van Santvoort HC, Besselink MGH, van der Heijden GJMG, Windsor JA, Gooszen HG. Enteral nutrition and the risk of mortality and infectious complications in patients with severe acute pancreatitis: a meta-analysis of randomized trials. Arch Surg [Internet]. 2008;143(11):1111–7. Available from: https://jamanetwork.com/journals/jamasurgery/article-abstract/402187 DOI: https://doi.org/10.1001/archsurg.143.11.1111
17. Pagliari D, Rinninella E, Cianci R, Attili F, Franza L, Luciano R, et al. Early oral vs parenteral nutrition in acute pancreatitis: a retrospective analysis of clinical outcomes and hospital costs from a tertiary care referral center. Intern Emerg Med [Internet]. 2020;15:613–9. Available from: https://link.springer.com/article/10.1007/s11739-019-02210-4 DOI: https://doi.org/10.1007/s11739-019-02210-4
18. Liao W-C, Tu T-C, Lee K-C, Tseng J-H, Chen M-J, Sun C-K, et al. Taiwanese consensus recommendations for acute pancreatitis. J Formos Med Assoc [Internet]. 2020;119(9):1343–52. Available from: https://www.sciencedirect.com/science/article/pii/S0929664619303195 DOI: https://doi.org/10.1016/j.jfma.2019.07.019
19. Kanthasamy KA, Akshintala VS, Singh VK. Nutritional management of acute pancreatitis. Gastroenterol Clin [Internet]. 2021;50(1):141–50. Available from: https://www.gastro.theclinics.com/article/S0889-8553(20)30108-4/abstract DOI: https://doi.org/10.1016/j.gtc.2020.10.014
20. Guato Canchinia DE, Maldonado Mariño EV, Ramos Velastegui AJ. Actualización sobre el manejo de la pancreatitis aguda. Rev Inf Cient [Internet]. 2024;103(1 Sup). Disponible en: https://revinfcientifica.sld.cu/index.php/ric/article/view/4567
21. Guida Acevedo GN, Franco Delgado RM, Aguilar Berrezueta RJ. Determinación de la frecuencia del síndrome de Burnout en el cuerpo docente de las facultades de ciencias médicas y ciencias jurídicas mediante la aplicación de la escala Maslach Burnout Inventory en la Universidad Regional Autónoma de los Andes, Sede Santo Domingo, durante el período de octubre de 2022 a Marzo de 2023. Dilemas contemp: educ política valores [Internet]. 2023 [cited 2024 Sep 14]; Available from: https://dilemascontemporaneoseducacionpoliticayvalores.com/index.php/dilemas/article/view/3892. DOI: https://doi.org/10.46377/dilemas.v11iEspecial.3892
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Copyright (c) 2024 Kevin René Lara Quinatoa , Cristina Augusta Altamirano López, Cristian Javier Calle Cárdenas (Author)
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