Comparison of clinical efficacy between early low and high enteral nutrition (EN) administration in the early treatment of hyperlipidemic severe acute pancreatitis / 肠外与肠内营养

ABSTRACT

Objective: This study aimed to compare the effects of high versus low calorie early enteral nutrition (EEN) administration on the complications and prognosis of hyperlipidemic acute pancreatitis (HLAP) patients. Methods: In this study, HLAP patients were randomly divided into high calorie EEN group and low calorie EEN group. The nutritional support was carried out within 48h at patients' admission. The serum lipid levels, inflammatory parameters, the incidence of EN intolerance, hospitalization duration, ICU duration, the incidence of organ failure and infected pancreatic necrosis as well as mortality rate were recorded and compared between two groups. Results: 48 patients with diagnosis of HLAP were included in this study from January 2014 to June 2017. In the first two days, the serum lipid levels of patients in low-calorie group decreased gradually. The serum lipid levels of the two groups were 2. 3 (1. 7-3. 4) mmol/L versus 5. 2 (2. 9-6. 1) mmol/L (P = 0. 05) respectively on third day after EN administration. There was no significant difference in the incidence of MODS and mortality rate between the two groups while the ICU duration of low-calorie group was significantly shorter than that in high-calorie group. The incidence of IPN in low-calorie group showed an elevated trend but there was no statistical significance. Conclusion: For HLAP patients, low calorie-high protein nutrition supply could benefit the patients to gain lean body weight due to the positive nitrogen balance, and to consume body fat due to the deficiency of calories. It is an effective nutrition support strategy for the patients' recovery.