Shahnaz Sultan, MD; Chris E. Forsmark, MD
In patients with acute pancreatitis, how do enteral and parenteral nutrition compare with no supplementary nutrition?
Studies selected compared standard enteral or parenteral nutrition with no supplementary nutrition, or enteral nutrition with parenteral nutrition in patients with acute pancreatitis. Outcomes were infectious complications and mortality.
MEDLINE, EMBASE/Excerpta Medica, Cochrane Central Register of Controlled Trials, and reference lists were searched to January 2008 for randomized controlled trials (RCTs). 15 RCTs (n = 617) met the selection criteria.
Meta-analysis showed that parenteral nutrition reduced mortality but not infectious complications compared with no supplementary nutrition (Table). Enteral nutrition reduced infectious complications but not mortality compared with parenteral nutrition (Table). Indirect adjusted meta-analysis showed that enteral nutrition reduced mortality (relative risk [RR] 0.2, 95% CI 0.07 to 0.7) but not infectious complications (RR 0.6, CI 0.07 to 4.3) compared with no supplementary nutrition.
Enteral or parenteral nutrition reduces risk for mortality compared with no supplementary nutrition in acute pancreatitis.
Comparisons of enteral nutrition (EN), parenteral nutritional (PN), and no supplementary nutrition (NSN) in acute pancreatitis*
*Abbreviations defined in Glossary. RRR, RRI, NNT, NNH, and CI calculated from control event rates and relative risks in article using a random-effects model.
Sultan S, Forsmark CE. Review: Enteral or parenteral nutrition reduces risk for mortality in acute pancreatitis. Ann Intern Med. ;149:JC6–6. doi: 10.7326/0003-4819-149-12-200812160-02006
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Published: Ann Intern Med. 2008;149(12):JC6-6.
Gastroenterology/Hepatology, Pancreatic Disease.
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