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 23 May 2018

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News

Early versus delayed feeding in patients with acute pancreatitis

This month's issue of the Annals of Internal Medicine compares length of hospital stay, mortality, and readmission in adults hospitalized with pancreatitis who received early versus delayed feeding.

News image

Acute pancreatitis is among the most common and costly reasons for hospitalization in the United States.

Bowel rest, pain control, and intravenous fluids are the cornerstones of treatment, but early feeding might also be beneficial.

Dr Vaughn Valerie and colleagues compared length of hospital stay, mortality, and readmission in adults hospitalized with pancreatitis who received early versus delayed feeding.

The team searched MEDLINE via Ovid, EMBASE, the Cochrane Library, CINAHL, and Web of Science through 2017.

Early feeding was associated with reduced length of stay in 4 of 7 studies
Annals of Internal Medicine

There were 2 authors that independently reviewed and selected studies if they were randomized clinical trials, included adults hospitalized with acute pancreatitis, and compared early versus delayed feeding.

The team reported that 2 investigators independently extracted study data and rated risk of bias using the Cochrane Collaboration tool.

The researchers identified 11 randomized trials that included 948 patients were eligible.

The team reported that 7 trials enrolled patients with mild to moderate pancreatitis.

The research team observed 4 trials that included patients with predicted severe pancreatitis.

Routes used for early feeding included oral, nasogastric, nasojejunal, and oral or nasoenteric.

Among patients with mild to moderate pancreatitis, early feeding was associated with reduced length of stay in 4 of 7 studies.

Other outcomes were heterogeneous and variably reported, but no study showed an increase in adverse events with early feeding.

Among patients with severe pancreatitis, the team found limited evidence that revealed no statistically significant difference in outcomes between early and delayed feeding.

Dr Valerie's team concludes, "Limited data suggest that early feeding in patients with acute pancreatitis does not seem to increase adverse events and, for patients with mild to moderate pancreatitis, may reduce length of hospital stay."

Ann Intern Med 2017;166(12):883-892
03 July 2017

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