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Systematic review and meta-analysis of enteral nutrition formulations in acute pancreatitis.
Br J Surg. 2009 Nov; 96(11):1243-52.BJ

Abstract

BACKGROUND

Although the benefits of enteral nutrition in acute pancreatitis are well established, the optimal composition of enteral feeding is largely unknown. The aim of the study was to compare the tolerance and safety of enteral nutrition formulations in patients with acute pancreatitis.

METHODS

Electronic databases (Scopus, MEDLINE, Cochrane Controlled Clinical Trials Register) and the proceedings of major pancreatology conferences were searched.

RESULTS

Twenty randomized controlled trials, including 1070 patients, met the inclusion criteria. None of the following was associated with a significant difference in feeding intolerance: the use of (semi)elemental versus polymeric formulation (relative risk (RR) 0.62 (95 per cent confidence interval (c.i.) 0.10 to 3.97); P = 0.611); supplementation of enteral nutrition with probiotics (RR 0.69 (95 per cent c.i. 0.43 to 1.09); P = 0.110); or immunonutrition (RR 1.60 (95 per cent c.i. 0.31 to 8.29); P = 0.583). The risk of infectious complications and death did not differ significantly in any of the comparisons.

CONCLUSION

The use of polymeric, compared with (semi)elemental, formulation does not lead to a significantly higher risk of feeding intolerance, infectious complications or death in patients with acute pancreatitis. Neither the supplementation of enteral nutrition with probiotics nor the use of immunonutrition significantly improves the clinical outcomes.

Authors+Show Affiliations

Department of Surgery, School of Medicine, University of Auckland, Auckland, New Zealand. max.petrov@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

19847860

Citation

Petrov, M S., et al. "Systematic Review and Meta-analysis of Enteral Nutrition Formulations in Acute Pancreatitis." The British Journal of Surgery, vol. 96, no. 11, 2009, pp. 1243-52.
Petrov MS, Loveday BP, Pylypchuk RD, et al. Systematic review and meta-analysis of enteral nutrition formulations in acute pancreatitis. Br J Surg. 2009;96(11):1243-52.
Petrov, M. S., Loveday, B. P., Pylypchuk, R. D., McIlroy, K., Phillips, A. R., & Windsor, J. A. (2009). Systematic review and meta-analysis of enteral nutrition formulations in acute pancreatitis. The British Journal of Surgery, 96(11), 1243-52. https://doi.org/10.1002/bjs.6862
Petrov MS, et al. Systematic Review and Meta-analysis of Enteral Nutrition Formulations in Acute Pancreatitis. Br J Surg. 2009;96(11):1243-52. PubMed PMID: 19847860.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Systematic review and meta-analysis of enteral nutrition formulations in acute pancreatitis. AU - Petrov,M S, AU - Loveday,B P T, AU - Pylypchuk,R D, AU - McIlroy,K, AU - Phillips,A R J, AU - Windsor,J A, PY - 2009/10/23/entrez PY - 2009/10/23/pubmed PY - 2009/12/16/medline SP - 1243 EP - 52 JF - The British journal of surgery JO - Br J Surg VL - 96 IS - 11 N2 - BACKGROUND: Although the benefits of enteral nutrition in acute pancreatitis are well established, the optimal composition of enteral feeding is largely unknown. The aim of the study was to compare the tolerance and safety of enteral nutrition formulations in patients with acute pancreatitis. METHODS: Electronic databases (Scopus, MEDLINE, Cochrane Controlled Clinical Trials Register) and the proceedings of major pancreatology conferences were searched. RESULTS: Twenty randomized controlled trials, including 1070 patients, met the inclusion criteria. None of the following was associated with a significant difference in feeding intolerance: the use of (semi)elemental versus polymeric formulation (relative risk (RR) 0.62 (95 per cent confidence interval (c.i.) 0.10 to 3.97); P = 0.611); supplementation of enteral nutrition with probiotics (RR 0.69 (95 per cent c.i. 0.43 to 1.09); P = 0.110); or immunonutrition (RR 1.60 (95 per cent c.i. 0.31 to 8.29); P = 0.583). The risk of infectious complications and death did not differ significantly in any of the comparisons. CONCLUSION: The use of polymeric, compared with (semi)elemental, formulation does not lead to a significantly higher risk of feeding intolerance, infectious complications or death in patients with acute pancreatitis. Neither the supplementation of enteral nutrition with probiotics nor the use of immunonutrition significantly improves the clinical outcomes. SN - 1365-2168 UR - https://www.unboundmedicine.com/medline/citation/19847860/Systematic_review_and_meta_analysis_of_enteral_nutrition_formulations_in_acute_pancreatitis_ L2 - https://doi.org/10.1002/bjs.6862 DB - PRIME DP - Unbound Medicine ER -