ESPEN guidelines on enteral nutrition:: Pancreas

被引:195
作者
Meier, R. [1 ]
Ockenga, J.
Pertkiewicz, M.
Pap, A.
Milinic, N.
MacFie, J.
Loeser, C.
Keim, V.
机构
[1] Kantonsspital Liestal, Dept Gastroenterol, CH-4410 Liestal, Switzerland
[2] Charite Univ Med Berlin, CCM, Dept Gastroenterol, Berlin, Germany
[3] Cent Clin Hosp, Dept Nutr & Surg, Warsaw, Poland
[4] MAV Hosp, Dept Gastroenterol 1, Budapest, Hungary
[5] Univ Hosp Bezanijska Kosa, Dept Gastroenterol, Belgrade, Serbia Monteneg
[6] Scarborough Gen Hosp, Dept Surg, Scarborough, ON, Canada
关键词
guideline; clinical practice; enteral nutrition; oral nutritional supplements; tube feeding; pancreatitis; undernutrition; malnutrition;
D O I
10.1016/j.clnu.2006.01.019
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
The two major forms of inflammatory pancreatic diseases, acute and chronic pancreatitis, require different approaches in nutritional management, which are presented in the present guideline. This clinical practice guideline gives evidence-based recommendations for the use of ONS and TF in these patients. It was developed by an interdisciplinary expert group in accordance with officially accepted standards and is based on all relevant publications since 1985. The guideline was discussed and accepted in a consensus conference. In mild acute pancreatitis enteral nutrition (EN) has no positive impact on the course of disease and is only recommended in patients who cannot consume normal food after 5-7 days. In severe necrotising pancreatitis EN is indicated and should be supplemented by parenteral. nutrition if needed. In the majority of patients continuous TF with peptide-based formulae is possible. The jejunal route is recommended if gastric feeding is not tolerated. In chronic pancreatitis more than 80% of patients can be treated adequately with normal food supplemented by pancreatic enzymes. 10-15% of all patients require nutritional supplements, and in approximately 5% tube feeding is indicated. The full version of this article is available at www.espen.org. (C) 2006 European Society for Clinical Nutrition and Metabolism. All rights reserved.
引用
收藏
页码:275 / 284
页数:10
相关论文
共 77 条
  • [1] Abou-Assi S, 2002, AM J GASTROENTEROL, V97, P2255, DOI 10.1111/j.1572-0241.2002.05979.x
  • [2] Necrotizing pancreatitis - Contemporary analysis of 99 consecutive cases
    Ashley, SW
    Perez, A
    Pierce, EA
    Brooks, DC
    Moore, FD
    Whang, EE
    Banks, PA
    Zinner, MJ
    [J]. ANNALS OF SURGERY, 2001, 234 (04) : 572 - 579
  • [3] ENERGY-EXPENDITURE DURING SEVERE ACUTE-PANCREATITIS
    BOUFFARD, YH
    DELAFOSSE, BX
    ANNAT, GJ
    VIALE, JP
    BERTRAND, OM
    MOTIN, JP
    [J]. JOURNAL OF PARENTERAL AND ENTERAL NUTRITION, 1989, 13 (01) : 26 - 29
  • [4] Bradley E L 3rd, 2000, JOP, V1, P1
  • [5] BRADLEY EL, 1993, ARCH SURG-CHICAGO, V128, P586
  • [6] Büchler MW, 2000, ANN SURG, V232, P619
  • [7] PARENTERAL-NUTRITION IS ASSOCIATED WITH INTESTINAL MORPHOLOGIC AND FUNCTIONAL-CHANGES IN HUMANS
    BUCHMAN, AL
    MOUKARZEL, AA
    BHUTA, S
    BELLE, M
    AMENT, ME
    ECKHERT, CD
    HOLLANDER, D
    GORNBEIN, J
    KOPPLE, JD
    VIJAYAROGHAVAN, SR
    [J]. JOURNAL OF PARENTERAL AND ENTERAL NUTRITION, 1995, 19 (06) : 453 - 460
  • [8] Medium-chain triglyceride absorption in patients with pancreatic insufficiency
    Caliari, S
    Benini, L
    Sembenini, C
    Gregori, B
    Carnielli, V
    Vantini, I
    [J]. SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 1996, 31 (01) : 90 - 94
  • [9] ACUTE-PANCREATITIS WITH HYPERLIPEMIA - EVIDENCE FOR A PERSISTENT DEFECT IN LIPID-METABOLISM
    CAMERON, JL
    CAPUZZI, DM
    ZUDEMA, GD
    MARGOLIS, S
    [J]. AMERICAN JOURNAL OF MEDICINE, 1974, 56 (04) : 482 - 487
  • [10] ACUTE PANCREATITIS WITH HYPERLIPEMIA - INCIDENCE OF LIPID ABNORMALITIES IN ACUTE PANCREATITIS
    CAMERON, JL
    CAPUZZI, DM
    ZUIDEMA, GD
    MARGOLIS, S
    [J]. ANNALS OF SURGERY, 1973, 177 (04) : 483 - 489