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Int. J. Mol. Sci. 2016, 17(10), 1691; doi:10.3390/ijms17101691

Meta-Analysis of Early Nutrition: The Benefits of Enteral Feeding Compared to a Nil Per Os Diet Not Only in Severe, but Also in Mild and Moderate Acute Pancreatitis

1
Institute for Translational Medicine, University of Pécs, Pécs H-7624, Hungary
2
Institute of Bioanalysis, University of Pécs, Pécs H-7624, Hungary
3
Department of Gastroenterology, First Department of Medicine, University of Pécs, Pécs H-7624, Hungary
4
First Department of Surgery, Semmelweis University, Budapest H-1085, Hungary
5
First Department of Pediatrics, Semmelweis University, Budapest H-1083, Hungary
6
Heim Pál Children’s Hospital, Budapest H-1089, Hungary
7
Translational Gastroenterology Research Group, Hungarian Academy of Sciences, University of Szeged, Szeged H-6720, Hungary
8
First Department of Medicine, University of Szeged, Szeged H-6720, Hungary
*
Author to whom correspondence should be addressed.
Academic Editors: Jaya Padmanabhan and Srikumar Chellappan
Received: 4 July 2016 / Revised: 10 September 2016 / Accepted: 27 September 2016 / Published: 20 October 2016
(This article belongs to the Special Issue Pancreatic Disorders)
View Full-Text   |   Download PDF [3179 KB, uploaded 20 October 2016]   |  

Abstract

The recently published guidelines for acute pancreatitis (AP) suggest that enteral nutrition (EN) should be the primary therapy in patients suffering from severe acute pancreatitis (SAP); however, none of the guidelines have recommendations on mild and moderate AP (MAP). A meta-analysis was performed using the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P). The following PICO (problem, intervention, comparison, outcome) was applied: P: nutrition in AP; I: enteral nutrition (EN); C: nil per os diet (NPO); and O: outcome. There were 717 articles found in Embase, 831 in PubMed, and 10 in the Cochrane database. Altogether, seven SAP and six MAP articles were suitable for analyses. In SAP, forest plots were used to illustrate three primary endpoints (mortality, multiorgan failure, and intervention). In MAP, 14 additional secondary endpoints were analyzed (such as CRP (C-reactive protein), WCC (white cell count), complications, etc.). After pooling the data, the Mann–Whitney U test was used to detect significant differences. Funnel plots were created for testing heterogeneity. All of the primary endpoints investigated showed that EN is beneficial vs. NPO in SAP. In MAP, all of the six articles found merit in EN. Analyses of the primary endpoints did not show significant differences between the groups; however, analyzing the 17 endpoints together showed a significant difference in favor of EN vs. NPO. EN is beneficial compared to a nil per os diet not only in severe, but also in mild and moderate AP. View Full-Text
Keywords: enteral feeding; acute pancreatitis; early nutrition; energy; meta-analysis enteral feeding; acute pancreatitis; early nutrition; energy; meta-analysis
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Márta, K.; Farkas, N.; Szabó, I.; Illés, A.; Vincze, Á.; Pár, G.; Sarlós, P.; Bajor, J.; Szűcs, Á.; Czimmer, J.; Mosztbacher, D.; Párniczky, A.; Szemes, K.; Pécsi, D.; Hegyi, P. Meta-Analysis of Early Nutrition: The Benefits of Enteral Feeding Compared to a Nil Per Os Diet Not Only in Severe, but Also in Mild and Moderate Acute Pancreatitis. Int. J. Mol. Sci. 2016, 17, 1691.

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