Acute Pancreatitis Clinical Trial
Official title:
The Correlations Between Early Enteral Nutrition and Intra-abdominal Pressure in Severe Acute Pancreatitis
As an important management of severe acute pancreatitis (SAP), enteral nutrition (EN),
especially early enteral nutrition (EEN) increases the blood flow of gut mucosa and
stimulates the intestinal motility. Moreover, EEN maintains the gut integrity, prevents
bacterial and endotoxin translocation and thereby theoretically reduces the incidence of
infections. Therefore, EEN has the ability to reduce the infectious complications, length of
hospital stay and mortality of patients with SAP.
However, the role of EEN is considered to be influenced by intra-abdominal hypertension
(IAH) in patients with SAP. The previous studies showed that gut was the most sensitive
splanchnic organ to the increase of intra-abdominal pressure (IAP). When IAH occurs, it
reduces the blood flow of gut, and then results in the development of intestinal ischemia
and edema. The hypoxia and hypoperfusion of intestine leads to the increase of permeability
of the intestinal mucosal barrier, and then leads to bacterial translocation. Therefore, IAH
could result in the gastrointestinal dysfunction. Nevertheless, the different impacts of
specific IAP values on the tolerance of EEN have not been reported.
Furthermore, the effects of early enteral feeding on the IAP in SAP also remain unknown. Due
to the severe inflammatory response of SAP, could EEN increase the burden of bowel, cause
expansion of intestinal cavity, thus increase IAP? However, there were rare literatures up
to date reporting the association between EEN and IAH in patients with SAP. Therefore, the
present study aimed to investigate the influence of specific IAP on the tolerance of early
enteral feeding, as well as the effects of EEN on IAP in SAP patients. Moreover, the impacts
of EEN on the disease severity and clinical outcome of SAP were also researched.
n/a
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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