The utilization of oral feeding in pediatric pancreatitis: a randomized controlled study
Yan Han1, Hong Zhao1, Linchen Fu1
1Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China.
Insights
Early oral feeding is effective for pediatric acute pancreatitis (AP), showing similar pain duration and weight changes compared to nasogastric (NG) feeding. Oral feeding may reduce complications in children with mild to moderate AP.
Area of Science:
- Pediatric Gastroenterology
- Nutritional Therapy
- Acute Pancreatitis Research
Background:
- Early nutritional intervention is crucial for children with acute pancreatitis (AP).
- Comparing oral feeding versus nasogastric (NG) feeding is essential for optimizing AP management in pediatric patients.
Purpose of the Study:
- To compare the efficacy and safety of oral feeding versus NG feeding in children with mild to moderately severe AP.
- To evaluate outcomes including pain duration, nutritional tolerance, and weight changes.
Main Methods:
- A prospective, randomized controlled trial involving 48 pediatric patients with mild to moderate AP.
- Participants were randomized into oral feeding or NG feeding groups.
- Primary outcomes assessed were AP-related pain duration, tolerance rate, and weight changes.
Main Results:
- No significant differences were observed in pain duration (3 days median for both groups) or tolerance rates between oral and NG feeding groups.
- Weight changes were comparable between groups at discharge and follow-up points (1 and 5 weeks post-discharge).
- Fewer complications were noted in the oral feeding group (0) compared to the NG group (4), though this difference was not statistically significant (p=0.109).
Conclusions:
- Oral feeding is a safe and effective nutritional strategy for children with mild to moderate AP.
- This approach can potentially reduce the need for invasive procedures like NG tube placement.
- Oral feeding demonstrates comparable efficacy to NG feeding regarding pain and weight, with a trend towards fewer complications.
Objective:
There is increasing awareness of the benefits of early nutritional intervention in children with acute pancreatitis (AP). This study aims to compare oral feeding with NG feeding in mild to moderately severe AP patients.
Methods:
A single-center, prospective, randomized controlled trial was conducted from September 2021 to August 2024. The participants were randomly assigned to the oral feeding group or the NG feeding group. The primary outcomes were the duration of AP-related pain, tolerance rate, and changes in weight.
Results:
A total of 56 pediatric patients were enrolled, of whom 48 patients (24 in each group) were included in the final analysis. There were no significant differences in baseline characteristics or etiological analysis results between the two groups. The median duration of abdominal pain after admission was 3 days in both groups (p = 0.104); no difference was found in the tolerance rate between the 2 cohorts (p = 0.489). There were no significant differences in weight change between the two groups at discharge or at 1 week or 5 weeks after discharge (p = 0.658, 0.502, and 0.927, respectively), and both groups presented slight increases in weight at 5 weeks post-discharge. Four patients in the NG group developed complications, while no complications were observed in the ORAL group (p = 0.109).
Conclusions:
Oral feeding is effective for nutritional therapy in children with mild to moderately severe AP, reducing the number of invasive procedures, without significant adverse effects.
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