Incidence and risk factors of nasogastric feeding intolerance in moderately-severe to severe acute pancreatitis

BMC Gastroenterology

卷:22

Zirui Liu¹  Lu Ke¹  Gang Li¹  Weiqin Li¹  Jiajia Lin¹  Zhihui Tong¹  Cheng Lv¹  He Zhang²  Cuili Wu³  Jianfeng Tu⁴ 

[1] Center of Severe Acute Pancreatitis (CSAP), Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University;

[2] Department of Critical Care Medicine, Jinling Hospital, Medical School of Southeast University;

[3] Department of General Surgery, Jinling Hospital, Medical School of Nanjing University;

[4] Emergency and Critical Care Center, Department of Emergency Medicine, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College;

关键词: Enteral nutrition;    Feeding intolerance;    Acute pancreatitis;    Jejunal feeding;    Prognosis;   

DOI  :  10.1186/s12876-022-02403-w

来源: DOAJ

【 摘 要 】

Abstract Background The importance of enteral nutrition (EN) in acute pancreatitis (AP) has been emphasised. Nasogastric (NG) feeding has been the preferred route for EN delivery in most AP patients intolerant to oral intake. However, gastric feeding intolerance (GFI) was frequently reported, especially in patients with more severe diseases. This study aimed to investigate the incidence and risk factors for GFI in moderately-severe to severe AP. Methods This is a single-centre, retrospective study. All the data were extracted from an electronic database from April 2020 to May 2021. Data were prospectively collected during hospitalisation. Patients diagnosed with moderately-severe to severe AP and admitted within seven days from the onset of abdominal pain were assessed for eligibility. Patients who showed signs of intolerance to gastric feeding and required switching to nasojejunal (NJ) feeding were deemed GFI. Multivariable logistic regression was performed to assess potential risk factors of GFI. Results A total of 93 patients were analysed, of whom 24 were deemed GFI (25.8%), and the rest tolerated NG feeding well (n = 69). In patients with GFI, the median time of switching to NJ feeding was five days (interquartile range: 4–7 days) after admission. The multivariable analysis showed that respiratory failure (odds ratio = 3.135, 95% CI: 1.111–8.848, P = 0.031) was an independent risk factor for GFI.The mean daily energy delivery in the following three days after switching to NJ feeding was significantly higher than the first three days after initiation of NG feeding in patients with GFI [920.83 (493.33–1326) vs. 465 (252.25–556.67) kcal, P < 0.001]. Conclusion GFI is common in moderately-severe to severe AP patients with an incidence of 25.8%, and the presence of respiratory failure may increase the risk of GFI.

【 授权许可】

Unknown