Department of Paediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warszawa, Poland.
Nutrients. 2022 Aug 22;14(16):3441. doi: 10.3390/nu14163441.
Nowadays, nutrition is said to be an integral aspect of acute pancreatitis (AP) treatment. Early enteral nutrition (EEN) is safe and beneficial for patients. This was confirmed by clinical experience and can be found in guidelines on managing adults with AP. Furthermore, paediatric recommendations encourage EEN use in AP. However, paediatric guidelines are based exclusively on studies in adults. Therefore, we present a review of published studies on the time of nutritional interventions in children with AP. A search was independently conducted in April 2022 by two of the authors. Only full-text papers published in English involving children between 0-21 were considered. Only four papers met our inclusion criteria: one randomised-control trial (RCT), one prospective study with retrospective chart review, and two retrospective chart reviews. All studies supported EEN and there was no recommendation of any delay in its initiation. The results of all four papers suggested EEN with a regular, normal-fat diet. EEN is safe in children with mild or moderately severe AP and may decrease the length of hospitalisation. Unfortunately, all the conclusions are based on a small amount of heterogeneous data that are mostly retrospective. Future prospective RCTs are needed.
如今,营养被认为是急性胰腺炎(AP)治疗的一个组成部分。早期肠内营养(EEN)对患者是安全且有益的。这一点得到了临床经验的证实,也可以在管理成人 AP 的指南中找到。此外,儿科指南鼓励在 AP 中使用 EEN。然而,儿科指南完全基于成人研究。因此,我们回顾了已发表的关于儿童 AP 中营养干预时机的研究。两位作者于 2022 年 4 月独立进行了检索。仅纳入了发表在英文期刊上、涉及 0-21 岁儿童的全文论文。只有 4 篇论文符合我们的纳入标准:1 项随机对照试验(RCT)、1 项前瞻性研究和回顾性图表审查,以及 2 项回顾性图表审查。所有研究都支持 EEN,且没有提出延迟开始 EEN 的建议。这 4 篇论文的结果均表明,EEN 联合常规低脂饮食是安全的。EEN 可用于治疗轻度或中度重症 AP 患儿,且可能会缩短住院时间。遗憾的是,所有结论均基于数量较少且异质性较大的回顾性数据。未来需要开展前瞻性 RCT 研究。