Enteral nutrition better for ICU patients with severe pancreatitis

Last Updated: 2017-09-27

By Scott Baltic

NEW YORK (Reuters Health) - For patients with severe pancreatitis in an intensive care unit, enteral nutrition (EN) is associated with lower rates of overall mortality and multiple organ failure, compared with parenteral nutrition (PN), according to a meta-analysis.

Researchers at the University of South China, Henyang, analyzed data from five relevant randomized controlled trials of EN versus PN. The studies involved 348 critically ill adults with severe pancreatitis who had been admitted to ICUs.

The aggregated data showed significantly lower overall mortality risk with EN than with PN (risk ratio, 0.36; P=0.001). Data from four studies that reported multiple organ failure showed that the risk of that outcome also was lower with EN than PN (RR, 0.39: P=0.003).

The report was published online September 13 in the European Journal of Clinical Nutrition.

"This analysis looks at a rather small subsection of the studies done to assess the best feeding route for patients with severe pancreatitis. It is unlikely to have much impact both because of its size, and because existing practice guidelines are already in line with the findings," Dr. David S. Seres, director of medical nutrition at Columbia University Medical Center, New York, told Reuters Health by email. He was not involved in the current study.

Meta-analysis with small aggregate numbers of patients are not reliable, he noted.

"Whether the patients are in an ICU or not, enteral feeding has been favored in guidelines, over parenteral nutrition, for patients with severe pancreatitis for some time," he added.

"Whether practitioners adhere to guidelines is another matter, and I would wager that there are numerous hospitals where parenteral nutrition is still the go-to for these patients. But if they are ignoring national guidelines, a meta-analysis of a small number of patients is unlikely to have impact," Dr. Seres said.

The study's corresponding author did not reply to requests for comment.

SOURCE: http://go.nature.com/2wE9NFk

Eur J Clin Nutr 2017.