Review: enteral nutrition reduces infections, need for surgica intervention, and length of hospital stay more than parentera nutrition in acute pancreatitis

摘要

The review by Marik et al recommends the use of EN For patients with AP. Based on the poor quality of the included studies, the pooled effect could be an overestimation.However, existing studies with various levels of evidence also provide support for the use of EN for severely ill patients.Patients with AP are a very specific disease population, and the issues related to providing EN to these patients may differ from those related to more general patient populations. For example, enteral feeding of patients with AP requires that nurses be able to recognise the link between deterioration of AP symptoms and possible dislocation of the feeding tube or symptoms related to an overload of food in the small intestine. Attention to feeding tube positioning, measurement of gastric retention and EN, and feeding pump controlled administration is important for AP patients.Optimal EN in the intensive care unit often fails because EN gets less attention than other life saving technologies. Studies of feeding intake have shown that optimal feeding rarely is achieved in >50% of patients. Therefore, the positive effects shown in efficacy studies may be diluted by the daily reality of clinical practice. The success of EN feeding will be determined largely by the quality of nursing practice.