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Advanced enteral therapy in acute pancreatitis: is there a room for immunonutrition? A meta-analysis.
Int J Surg. 2008 Apr; 6(2):119-24.IJ

Abstract

BACKGROUND

It is believed that certain nutrients such as glutamine, arginine and omega-3 fatty acids may play a significant role in metabolic, inflammatory, and immune processes in acute pancreatitis. The present systematic review aimed to define whether the addition of these substances to enteral nutrition provides any clinical benefit over standard enteral formulas in patients with acute pancreatitis.

METHODS

A computerized search on electronic databases (Cochrane Central Register of Controlled Trials, EMBASE and MEDLINE) and manual search of the abstracts of major gastroenterological meetings (UEGW, DDW) were undertaken. The studied outcomes were total infectious complication, in-hospital mortality and length of hospital stay. The data were meta-analyzed using a random-effects model.

RESULTS

A total of three randomized controlled trials satisfied the inclusion criteria. When compared with standard enteral nutrition, immunonutrition was not associated with the significantly reduced risk of total infectious complications (risk ratio 0.82; 95% confidence interval 0.44-1.53; P=0.53) and death (risk ratio 0.64; 95% confidence interval 0.20-2.07; P=0.46). Mean difference in length of hospital stay between two groups was not significant (P=0.80).

CONCLUSIONS

There is no evidence that enteral nutrition supplemented with glutamine, arginine and/or omega-3 fatty acids, in comparison with standard enteral nutrition, has any beneficial effect on infectious complications, mortality or length of hospital stay in acute pancreatitis. The pursuit of new compositions of enteral formulations in this category of patients may be advocated.

Authors+Show Affiliations

Department of Surgery, Nizhny Novgorod State Medical Academy, PO Box 568, Nizhny Novgorod 603000, Russia. max.petrov@gmail.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

18325863

Citation

Petrov, Maxim S., et al. "Advanced Enteral Therapy in Acute Pancreatitis: Is There a Room for Immunonutrition? a Meta-analysis." International Journal of Surgery (London, England), vol. 6, no. 2, 2008, pp. 119-24.
Petrov MS, Atduev VA, Zagainov VE. Advanced enteral therapy in acute pancreatitis: is there a room for immunonutrition? A meta-analysis. Int J Surg. 2008;6(2):119-24.
Petrov, M. S., Atduev, V. A., & Zagainov, V. E. (2008). Advanced enteral therapy in acute pancreatitis: is there a room for immunonutrition? A meta-analysis. International Journal of Surgery (London, England), 6(2), 119-24. https://doi.org/10.1016/j.ijsu.2008.01.003
Petrov MS, Atduev VA, Zagainov VE. Advanced Enteral Therapy in Acute Pancreatitis: Is There a Room for Immunonutrition? a Meta-analysis. Int J Surg. 2008;6(2):119-24. PubMed PMID: 18325863.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Advanced enteral therapy in acute pancreatitis: is there a room for immunonutrition? A meta-analysis. AU - Petrov,Maxim S, AU - Atduev,Vagif A, AU - Zagainov,Vladimir E, Y1 - 2008/01/25/ PY - 2008/01/08/received PY - 2008/01/15/accepted PY - 2008/3/8/pubmed PY - 2008/6/17/medline PY - 2008/3/8/entrez SP - 119 EP - 24 JF - International journal of surgery (London, England) JO - Int J Surg VL - 6 IS - 2 N2 - BACKGROUND: It is believed that certain nutrients such as glutamine, arginine and omega-3 fatty acids may play a significant role in metabolic, inflammatory, and immune processes in acute pancreatitis. The present systematic review aimed to define whether the addition of these substances to enteral nutrition provides any clinical benefit over standard enteral formulas in patients with acute pancreatitis. METHODS: A computerized search on electronic databases (Cochrane Central Register of Controlled Trials, EMBASE and MEDLINE) and manual search of the abstracts of major gastroenterological meetings (UEGW, DDW) were undertaken. The studied outcomes were total infectious complication, in-hospital mortality and length of hospital stay. The data were meta-analyzed using a random-effects model. RESULTS: A total of three randomized controlled trials satisfied the inclusion criteria. When compared with standard enteral nutrition, immunonutrition was not associated with the significantly reduced risk of total infectious complications (risk ratio 0.82; 95% confidence interval 0.44-1.53; P=0.53) and death (risk ratio 0.64; 95% confidence interval 0.20-2.07; P=0.46). Mean difference in length of hospital stay between two groups was not significant (P=0.80). CONCLUSIONS: There is no evidence that enteral nutrition supplemented with glutamine, arginine and/or omega-3 fatty acids, in comparison with standard enteral nutrition, has any beneficial effect on infectious complications, mortality or length of hospital stay in acute pancreatitis. The pursuit of new compositions of enteral formulations in this category of patients may be advocated. SN - 1743-9159 UR - https://www.unboundmedicine.com/medline/citation/18325863/Advanced_enteral_therapy_in_acute_pancreatitis:_is_there_a_room_for_immunonutrition_A_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1743-9191(08)00013-7 DB - PRIME DP - Unbound Medicine ER -