Realimentacion digestiva en pancreatitis aguda: ¿Cuándo y cómo?

Background: Digestive refeeding in acute pancreatitis represent a dificult issue. It requires the rsolution of intestinal ileus and carries a risk of reactivation. Aim: To evaluate criteria that may guide in early refeeding avoiding unnecesary prolonged fasting. Patients and methods: Thirty patients...

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Autores principales:	Papapietro V,Karin, Marin E,Michel, Díaz G,Emma, Watkins S,Guillermo, Berger F,Zoltan, Rappoport S,Jaime
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2001
Materias:	Enteral nutrition Feeding methods Pancreatic,acute necrotizing
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872001000400007
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spelling	oai:scielo:S0034-988720010004000072003-04-10Realimentacion digestiva en pancreatitis aguda: ¿Cuándo y cómo?Papapietro V,KarinMarin E,MichelDíaz G,EmmaWatkins S,GuillermoBerger F,ZoltanRappoport S,Jaime Enteral nutrition Feeding methods Pancreatic,acute necrotizing Background: Digestive refeeding in acute pancreatitis represent a dificult issue. It requires the rsolution of intestinal ileus and carries a risk of reactivation. Aim: To evaluate criteria that may guide in early refeeding avoiding unnecesary prolonged fasting. Patients and methods: Thirty patients with acute pancreatitis were evaluated in a prospective trial. The severity of the pancreatitis was evaluated according to APACHE II score and Balthazar CT scan altertions. The criteria proposed to start early refeeding were abscence of nausea and vomiting, decreased abdominal pain, presence of bowel sounds and lowering of serum amylase levels. Balthazar CT scan clasification, was used to decide between oral or enteral refeeding. Results. Eighty percent of patients had alterations in pancreatic density, necrosis or pancretic or peripancreatic liquid collections in the CT scan (correspondig to Balthazar stages C,D,or E). Ten patients fullfilled the criteria for enteral refeeding at 8.1 ± 3.5 days (range 3 to 15 days), and 21 patients fulfilled criteria fo enteral refeeding at 8.7±4.5 (range 4-19). No patient had a reactivation of his pancreatitis. Conclusions. Digestive refeeding can be done safely by using the criteria proposed in this study. Pancreatic necrosis or peripancreatic fluid collections do not contraindicate refeeding. Oral feeding may be employed (as the first option) in selected patients, without increasing the riskof complication, regardless of CT scan alterations of the pancreas (Rev Méd Chile 2001;129: 396-391)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.129 n.4 20012001-04-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872001000400007es10.4067/S0034-98872001000400007
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Enteral nutrition Feeding methods Pancreatic,acute necrotizing
spellingShingle	Enteral nutrition Feeding methods Pancreatic,acute necrotizing Papapietro V,Karin Marin E,Michel Díaz G,Emma Watkins S,Guillermo Berger F,Zoltan Rappoport S,Jaime Realimentacion digestiva en pancreatitis aguda: ¿Cuándo y cómo?
description	Background: Digestive refeeding in acute pancreatitis represent a dificult issue. It requires the rsolution of intestinal ileus and carries a risk of reactivation. Aim: To evaluate criteria that may guide in early refeeding avoiding unnecesary prolonged fasting. Patients and methods: Thirty patients with acute pancreatitis were evaluated in a prospective trial. The severity of the pancreatitis was evaluated according to APACHE II score and Balthazar CT scan altertions. The criteria proposed to start early refeeding were abscence of nausea and vomiting, decreased abdominal pain, presence of bowel sounds and lowering of serum amylase levels. Balthazar CT scan clasification, was used to decide between oral or enteral refeeding. Results. Eighty percent of patients had alterations in pancreatic density, necrosis or pancretic or peripancreatic liquid collections in the CT scan (correspondig to Balthazar stages C,D,or E). Ten patients fullfilled the criteria for enteral refeeding at 8.1 ± 3.5 days (range 3 to 15 days), and 21 patients fulfilled criteria fo enteral refeeding at 8.7±4.5 (range 4-19). No patient had a reactivation of his pancreatitis. Conclusions. Digestive refeeding can be done safely by using the criteria proposed in this study. Pancreatic necrosis or peripancreatic fluid collections do not contraindicate refeeding. Oral feeding may be employed (as the first option) in selected patients, without increasing the riskof complication, regardless of CT scan alterations of the pancreas (Rev Méd Chile 2001;129: 396-391)
author	Papapietro V,Karin Marin E,Michel Díaz G,Emma Watkins S,Guillermo Berger F,Zoltan Rappoport S,Jaime
author_facet	Papapietro V,Karin Marin E,Michel Díaz G,Emma Watkins S,Guillermo Berger F,Zoltan Rappoport S,Jaime
author_sort	Papapietro V,Karin
title	Realimentacion digestiva en pancreatitis aguda: ¿Cuándo y cómo?
title_short	Realimentacion digestiva en pancreatitis aguda: ¿Cuándo y cómo?
title_full	Realimentacion digestiva en pancreatitis aguda: ¿Cuándo y cómo?
title_fullStr	Realimentacion digestiva en pancreatitis aguda: ¿Cuándo y cómo?
title_full_unstemmed	Realimentacion digestiva en pancreatitis aguda: ¿Cuándo y cómo?
title_sort	realimentacion digestiva en pancreatitis aguda: ¿cuándo y cómo?
publisher	Sociedad Médica de Santiago
publishDate	2001
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872001000400007
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Realimentacion digestiva en pancreatitis aguda: ¿Cuándo y cómo?

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