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Nutritional support in patients with acute pancreatitis
Giuseppe Piccinni1, Mario Testini, Anna Angrisano
1Section of General and Oncologic Surgery, Department of Biological Sciences and Human Oncology , University Medical School of Bari, Italy.
Frontiers in Bioscience (Elite Edition)
|December 29, 2011
Summary
Severe acute pancreatitis (SAP) management requires timely nutritional support. This review analyzes optimal nutritional strategies, including route and composition, to improve patient outcomes in SAP.
Area of Science:
- Gastroenterology and Hepatology
- Critical Care Medicine
- Surgical Nutrition
Background:
- Pancreatitis involves systemic inflammation and auto-digestion due to premature enzyme activation.
- Severe acute pancreatitis (SAP) has a high mortality rate (up to 20%), often linked to pancreatic necrosis and infection.
- Nutritional support is crucial in SAP due to accelerated catabolism, with the route of delivery impacting disease course.
Purpose of the Study:
- To review the current evidence on nutritional support in severe acute pancreatitis (SAP).
- To address key questions regarding the indication, timing, route (enteral vs. parenteral), and composition of nutritional support in SAP.
- To provide a decision-making flowchart for managing nutritional support in SAP patients.
Main Methods:
- Systematic review of the state-of-the-art in nutritional support for SAP.
- Analysis of current literature on enteral and parenteral nutrition in SAP.
- Development of a clinical decision flowchart for nutritional management.
Main Results:
- Nutritional support route significantly influences SAP severity and patient outcomes.
- Optimal timing, indication, and composition of nutritional support are critical for managing SAP.
- The review synthesizes current knowledge to guide clinical practice.
Conclusions:
- Effective nutritional support is vital for improving outcomes in severe acute pancreatitis.
- A structured approach, guided by evidence and a decision flowchart, is recommended for nutritional management in SAP.
- Further research into specific nutritional strategies may optimize SAP patient care.
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