Nutritional support of patients with severe acute pancreatitis

Rationale: research aim was the improvement of results of treatment of patients with severe acute pancreatitis and comparison of effectiveness of enteral and parenteral nutritional support

Methods: 43 patients (32 men and 11 women) aged from 30 up to 67 years old were on treating in intensive care unit (ICU) in the years 2004–2007. All patients were operated (laparotomy, draining). The severity of the state was estimated by the scale of Ranson and on APACHE-II. To outward seeming performed nutritional support of a patients are divided into two groups: at the first group (16 patients) has been carried out the total parenteral nutrition, beginning from 1–2 days of the treatment; in the second group (14 patients) – with 2–3 days the parenteral nutrition was complemented by the enteral delivery of nutrients through nasojejunal tube, or catheter jejunostomy.

Results: at the first group: circumference decrease of shoulder muscles on 5, 10 and 20 days (1,2cm, 2,2cm, 3,4cm) is higher than in the second group (1,0cm, 1,5cm, 2,5cm). Content changes of fat in the organism on 5, 10 and 20 days at the first group (4,9%, 9,4%, 12,3%) and in the second group (4,6%, 5,2%, 10,5%). Length of stay in ICU –6,8 and 4,6 days and period of hospitalization –32,3 and 20,6 days correspondingly. At the first group died 2 patients, in the second group – lethal accidents there was not.

Conclusions: The research conducted showed that in case of inclusion of early enteral feeding in addition to parenteral nutrition of patients with destructive pancreatitis, loss of as fat, and muscle mass is less marked, than in patients, obtaining total parenteral nutrition. Average duration of treatment in ICU, as well as the lethality in patients second group reliably is less than in patients of the first group.