Prospective study to evaluate the outcome of early enteral nutrition in severe acute pancreatitis.

Background and Objectives: Severe acute pancreatitis (SAP) affects the nutritional status of the patient. This prospective study was carried to assess the tolerance and outcome of early enteral nutrition via naso-jejunal feeding tube (NJFT).Methods: 30 patients of SAP were given enteral feeding via endoscopically inserted NJFT within 48 – 72 hours of admission. The volume of the feeds was increased as per tolerance. The patients who tolerated the feed (Group A) and those who did not tolerate (Group B) were followed up by biochemical parameters, amount and duration of feeding. The patient outcome noted and the results statistically analyzed. Results: 27 (90%) patients tolerated the feed, reached the goal feed volume and were subsequently started on oral feeds. No complication related to NJFT insertion was encountered. A significantly higher ICU stay (p=0.04) and number of complications (p = 0.048) was observed in Group B patients than in Group A. All nutritional parameters improved in patients in Group A with significant improvement in serum calcium, serum albumin and fasting blood glucose levels. Conclusion: Enteral nutrition is an economical and effective way to provide nutrition to patients with severe acute pancreatitis. The patients who tolerated feeds had less morbidity, mortality and hospital stay.

Effects of enteral nutrition by gastroscope-guided naso-jejunal feeding tube placement on acute severe pancreatitis endotoxemia / 中国综合临床

Objective To investigate the therapeutic effects of early enteral nutrition by gastroscopeguided naso-jejunal feeding tube placement on the intestinal endotoxemia of patient with severe acute pancreatitis (SAP).Methods Fourty-three patients were randomized into two groups:patients receiving early enteral nutrition (EN) by gastroscope-guided naso-jejunal feeding tube placement (24 cases) and those receiving total parenteral nutrition (TPN) ( 19 cases).The serum endotoxin(ET),albumin (ALB) and amylase (AMY) levels were measured.Abdominal distension and other complications were observed in the two groups.Results The abdominal pain and distension relief time,intestinal bleeding,infectious complications of EN group were significantly improved compared with that of TPN group ( P ＜ 0.01 或 P ＜ 0.05 或 P ＜ 0.001 ).The serum ET levels of EN group was much lower ( [ 0.19 ± 0.11 ] EU/ml) than that of TPN group ( [ 0.85 ± 0.28 ] EU/ml)on day 14 post-treatment (t =10.456,P ＜ 0.001 ).The serum AMY levels were decreased significantly in two groups after treatment,and the difference between two groups was not significant (t =3.l17,t =1.889,P ＞0.05 ).The serum ALB recovery of two groups was not significantly different ( P ＞ 0.05 ).Conclusion Gastroscope-guided Naso-jejunal feeding tube placement for early enteral nutrition can protect intestinal mucosa,reduce complications,alleviate symptoms of patients with SAP,which are benefitial factors for the treatment of intestinal endotoxemia in patients with SAP.

Application of naso-jejunal feeding tube in early enteral nutrition for patients with severe acute pancreatitis / 中国实用护理杂志

Objective To investigate the method and nursing care of early enteral nutrition through naso-jejunal feeding tube for patients with severe acute pancreatitis.Methods We retrospectively studied 37 patients with severe acute pancreatitis,who were given early enteral nutrition through naso-jejunum nutrition tube.Results Abdominal distention occurred in 5 patients,and 3 patients got mild diarrhea.No aspiration and SAP relapse occurred among 37 patients.All the patients were discharged from hospital after recovery.Conclusions Enteral nutrition through naso-jejunum nutrition tube is the main treatment and nutritional support measure for patients with severe acute pancreatitis.Daily care of the naso-jejunum nutrition tube,and prevention and treatment of complications are the critical work in SAP patients＇ nursing care.

The placement of naso-jejunal feeding tube under DSA guidance: its technology and skills / 介入放射学杂志

Objective To retrospectively analyze and summarize the manipulation and skills of the placement of uaso-jejunal feeding tube under DSA guidance. Methods After performing the spraying anesthesia of nasopharynx, the naso-jejunal feeding tube, with the help of guide wire and under DSA guidance, was placed into the proximal jejunum by passing it through the nose, pharynx, esophagus, stomach,pylorus and duodenum in order. The procedure was employed in 441 cases. Results The mean time for performing the procedure was within five minutes. The procedure was successfully accomplished in all 441 cases and no complications occurred in this series. Conclusion Under DSA guidance the placement of nasojejunal feeding tube can be safely and quickly carried out with high successful rate and less sufferings to patient. It is worth popularizing this technique in clinical practice.