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Background
The optimal timing of enteral nutrition (EN) initiation in predicted severe acute gallstone pancreatitis (SAGP) and its influence on disease outcomes are not well known.
Methods
We conducted a retrospective study of patients with predicted SAGP treated with endoscopic retrograde cholangiopancreatography and EN. The patients were classif...
Contexts in source publication
Context 1
... characteristics, presented in [14] vs. 16 [20] days; p=0.92) were similar between the two groups. Table 2 reports the clinical outcomes between the two groups. The overall in-hospital mortality was 8.2% (8/98). ...Context 2
... (Table 2) Infection with MDRO was diagnosed in 19.4% (19/98) of patients. It occurred in 5 patients (16.1%) in the early EN group, compared to 14 (20.9%) in the delayed EN group. ...Context 3
... significant difference was found between the two groups (p=0.78). (Table 2) In total, 25 isolates (27.5%) of MDRO were detected, of which 12 (48%) were MDR Gram-negative and 13 (52%) were MDR Gram-positive bacteria. No obvious drug resistance in fungi was observed. ...Context 4
... our cohort included a large proportion of patients with cholangitis (57.1%), which could have influenced the final results associated with infection. Third, we observed that early EN was associated with a trend toward a decreased incidence of infectious complications, as shown in Table 2. The differences between the two groups were not significant, probably because of the small sample size. ...Similar publications
Citations
... 18 Another study also showed that EN initiation within 48 h was associated with decreased in-hospital mortality and length of hospital stay compared with delayed EN (>48 h) in predicted severe acute gallstone pancreatitis. 19 In 2010, a retrospective investigation performed by Hegazi and colleagues found that the time to start jejunal feeding was much longer in nonsurvivors than in survivors (17 vs 7 days). 20 Because of the retrospective nature of the study, "survivor bias" can not be ruled out, because survivors may simply better tolerate EN feeding. ...
A significant proportion of patients (10%–20%) with acute pancreatitis develop severe acute pancreatitis characterized by pancreatic necrosis, systemic inflammation, and organ failure, commonly requiring intensive care unit (ICU) admission. In this specific population, nutrition therapy is more challenging than that in the general ICU population, primarily because of inevitable gastrointestinal involvement by pancreatic inflammation. In this review, we discussed several key aspects of nutrition therapy in this population, including key pathophysiology that may impede nutrition therapy, the timing and implementation of enteral nutrition and parenteral nutrition, the importance of specific nutrient supplements, and the long‐term outcomes that may be addressed by nutrition therapy.
Introduction
Enteral feeding is essential for hospitalized patients unable to consume oral nutrition. However, it poses a risk of bacterial contamination, leading to infections and increased morbidity and mortality.
Method
Studies have shown that contaminated enteral feeds are associated with longer hospital stays and worsened patient outcomes. Common pathogens include Gram-negative bacilli (e.g., Serratia spp., Klebsiella spp., Enterobacter spp.), coagulase-negative staphylococci, and Clostridium difficile. Preventing contamination requires identifying and mitigating potential routes. This comprehensive approach encompasses careful practices during production, storage, preparation, and administration of enteral feeds.
Result
Early initiation of enteral feeding has also been linked to lower infection rates. Standardized protocols, hand hygiene adherence, routine monitoring for infection signs, and ongoing staff education are crucial for safe enteral feeding. Further research is needed to better understand risk factors for contamination and evaluate the effectiveness of preventive interventions.
Conclusion
Addressing these knowledge gaps can significantly improve the quality of enteral feeding and reduce infection burden in hospitalized patients.
