The Correlations Between Early Enteral Nutrition and Intra-abdominal Pressure in Severe Acute Pancreatitis
Status:
Completed
Trial end date:
2011-09-01
Target enrollment:
Participant gender:
Summary
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.