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Pancreatitis, very early compared with normal start of enteral feeding (PYTHON trial): design and rationale of a

Olaf J Bakker1, Hjalmar C van Santvoort, Sandra van Brunschot

  • 1Dept, of OR/Evidence Based Surgery, Radboud University Nijmegen Medical Centre, PO 9101, 6500 HB Nijmegen; The Netherlands.

Trials
|March 12, 2011
PubMed

Insights

Early enteral nutrition (EN) within 24 hours significantly reduces mortality and infections in severe acute pancreatitis patients compared to delayed feeding. This approach improves clinical outcomes in critical care settings.

Area of Science:

  • Gastroenterology
  • Critical Care Medicine
  • Surgical Outcomes

Background:

  • Infections negatively impact outcomes in predicted severe acute pancreatitis.
  • Early enteral nutrition (EN) may reduce infections compared to current delayed feeding practices.

Purpose of the Study:

  • To evaluate if very early EN (< 24 hours) reduces mortality or infections in severe acute pancreatitis.
  • To compare early EN versus a delayed oral diet and EN (around 72 hours).

Main Methods:

  • The PYTHON trial is a randomized controlled, superiority, multicenter trial.
  • 208 patients with predicted severe acute pancreatitis were enrolled.
  • Primary endpoint: composite of mortality or infections within 6 months.

Main Results:

  • The PYTHON trial is designed to demonstrate the efficacy of early EN.
  • The study aims to show a reduction in the combined endpoint of mortality or infections.

Conclusions:

  • Very early EN (< 24 hours) is proposed to reduce mortality and infections.
  • This contrasts with the current practice of delayed EN initiation in severe acute pancreatitis.
Abstract

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