Assessment of gastrointestinal dysfunction in selection of an effective method of nutritional support in patients with acute pancreatitis.

Authors

  • E. Yu. Sorokina
  • L. S. Belykh
  • A. N. Panin
  • E. V. Nikitina
  • I. A. Kovrizhin
  • O. P. Strah

DOI:

https://doi.org/10.26641/2307-0404.2018.2.133950

Keywords:

acute severe pancreatitis, intraperitoneal pressure, dyspepsia, intestinal insufficiency, nutritional support methods

Abstract

Potential mortality in acute pancreatitis (AP) is 5%. Patients with AP represent II type of intestinal insufficiency, which occurs on the background of dyspeptic syndrome and increased intra-abdominal pressure (IAP). IAP is a differentiated indicator. With the increase of IAP more than 10 mmHg, intra-abdominal hypertension (IAH) arises. Increasing IAP to this level is considered as safe. Monitoring of IAP level allows to achieve better clinical results. Totally 47 patients with acute pancreatitis were examined. Depending on the function of the gastrointestinal tract and the selected type of starting nutritional support (NS), they were divided into 2 groups. The first group consisted of IAH patients of I degree and dyspeptic syndrome who underwent parenteral nutrition (PN) with 3-component compounds begun on the 2nd day of disease and after restoration of gastrointestinal tract function a late enteral feeding (LEF) was performed. In the second group, patients with AP were initially diagnosed with elevated IAP at a safe level and dyspeptic syndrome. They were prescribed early enteral nutrition (EEN) with specialized blends from the 2nd day of disease. In 2 days a significant reduction in pain syndrome with the persistence of dyspeptic syndrome and intestinal insufficiency (II) was recorded. In patients with intra-abdominal hypertension, total parenteral nutrition is the effective method of nutritional support, against which, after 5 days manifestations of dyspeptic syndrome and IAP indices decrease to a safe level. Therefore in-time detection of high level of intra-abdominal pressure in patients with acute pancreatitis can help to choose a more rational method of nutritional support.

Author Biographies

E. Yu. Sorokina

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine» 
Department of Medicine of Catastrophes and Military Medicine
V. Antonovicha str., 65, Dnepr, 49006, Ukraine

L. S. Belykh

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»

Department of Medicine of Catastrophes and Military Medicine
V. Antonovicha str., 65, Dnepr, 49006, Ukraine

A. N. Panin

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine» 
Department of Medicine of Catastrophes and Military Medicine
V. Antonovicha str., 65, Dnepr, 49006, Ukraine

E. V. Nikitina

PI «Dnepropetrovsk clinical association of emergency medical care» DRC
V. Antonovicha str., 65, Dnepr, 49006, Ukraine

I. A. Kovrizhin

PI «Dnepropetrovsk clinical association of emergency medical care» DRC 
V. Antonovicha str., 65, Dnepr, 49006, Ukraine

O. P. Strah

PI «Dnepropetrovsk clinical association of emergency medical care» DRC 
V. Antonovicha str., 65, Dnepr, 49006, Ukraine

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How to Cite

1.
Sorokina EY, Belykh LS, Panin AN, Nikitina EV, Kovrizhin IA, Strah OP. Assessment of gastrointestinal dysfunction in selection of an effective method of nutritional support in patients with acute pancreatitis. Med. perspekt. [Internet]. 2018Jun.25 [cited 2024Jun.25];23(2):125-30. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/133950

Issue

Section

CLINICAL MEDICINE