Nutricion hospitalaria · 1996
[Nutritional support in severe acute pancreatitis. Controlled clinical trial].
Клиническое исследованиеСравнительное исследованиеКонтролируемое клиническое исследованиеАннотация на английскомСтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Hernández-Aranda J C, Gallo-Chico B, Ramírez-Barba E J
Аннотация
INTRODUCTION: Severe acute pancreatitis is an ailment with a higher than 60% mortality. The nutritional support is a fundamental part of the treatment in these patients with the aim of ameliorating traumatic metabolic response.
AIM: To compare total effectiveness of parenteral nutrition and enteral nutrition through jejunostomy in postoperated patients for acute pancreatitis.
MATERIAL AND METHODS: A clinically controlled, longitudinal, prospective, experimental and at random survey was performed with our hospital's nutritional supportive service (which is a reference center) in a 16-month period. Patients postoperated on for severe pancreatitis were included (3 or more of Ranson's criteria), the ones who died before the first week were excluded. Group I was treated with total parenteral nutrition, and group II with enteral nutrition via jejunostomy through a silicon catheter placed at transoperative. The result variables were summed up at the beginning and every week for a 3-week period. The hipotheses were contrasted with Student's " t " test with a tail for independent samples of a 5% significance level.
RESULTS: Groups I and II were integrated by 12 and 10 patients respectively. Sex and ages were similar. Urine nitrogen was kept high in both groups, being group I the highest (ns). Nitrogen balance was kept close to neutrality in both groups (ns). Serum albumin levels were slightly increased in both groups (ns). The creatinine/size index showed loss of progressive muscular mass in both groups, being group II the lowest (p < 0,05). Total lymphocyte count depletion level improved from mild to normal in both groups, but being this more important in group II (p < 0,05). Global mortality was 40%.
CONCLUSIONS: Enteral nutrition was as effective as parenteral in these patients, having the advantage of being less expensive, easier to handle and with a lesser rate of septic complications. We consider that this must be the nutritional method of choice if there are contra indications for its use.
AIM: To compare total effectiveness of parenteral nutrition and enteral nutrition through jejunostomy in postoperated patients for acute pancreatitis.
MATERIAL AND METHODS: A clinically controlled, longitudinal, prospective, experimental and at random survey was performed with our hospital's nutritional supportive service (which is a reference center) in a 16-month period. Patients postoperated on for severe pancreatitis were included (3 or more of Ranson's criteria), the ones who died before the first week were excluded. Group I was treated with total parenteral nutrition, and group II with enteral nutrition via jejunostomy through a silicon catheter placed at transoperative. The result variables were summed up at the beginning and every week for a 3-week period. The hipotheses were contrasted with Student's " t " test with a tail for independent samples of a 5% significance level.
RESULTS: Groups I and II were integrated by 12 and 10 patients respectively. Sex and ages were similar. Urine nitrogen was kept high in both groups, being group I the highest (ns). Nitrogen balance was kept close to neutrality in both groups (ns). Serum albumin levels were slightly increased in both groups (ns). The creatinine/size index showed loss of progressive muscular mass in both groups, being group II the lowest (p < 0,05). Total lymphocyte count depletion level improved from mild to normal in both groups, but being this more important in group II (p < 0,05). Global mortality was 40%.
CONCLUSIONS: Enteral nutrition was as effective as parenteral in these patients, having the advantage of being less expensive, easier to handle and with a lesser rate of septic complications. We consider that this must be the nutritional method of choice if there are contra indications for its use.