Table 2.
Evidence regarding the optimal composition of enteral feeding (elemental, semi-elemental, or standard in acute pancreatitis.
| First Author | Year | Study Design | Type of Nutrition and Formula | Remarks |
|---|---|---|---|---|
| Windsor Ac. [106] | 1998 | CT | Standard formula vs. total parenteral nutrition. | Proving that enteral feeding modulates the inflammatory response with a consequent better clinical outcome, Windsor, for the first time, suggested the potential use of standard formulations in patients suffering from AP. |
| Gupta R. [107] | 2003 | RCT | Standard formula vs. parenteral nutrition | Early use of nutritional support in the form of TEN is safe in predicted SAP. |
| Powell JJ. [108] | 2000 | RCT | Standard formula vs. no nutritional interventions | Early enteral nutrition was found to have no effect on inflammatory response markers or on organ dysfunction. |
| Tiengou LE. [102] | 2006 | RCT | Standard formula vs. polymeric formula by NJ tube feeding. | Despite both formulations being well tolerated, within the semi-elemental group the infection rate and the median LOS were found to be shorter. |
| Pupelis G. [109] | 2001 | RCT | Standard formula by NJ tube feeding, | Standard formula by jejunal feeding, even when started late, improves outcomes in patients with SAP. |
| Makola D. [110] | 2006 | CT | Standard formula by NJ tube feeding. | Standard enteral formula is effective in the management of patients with complicated AP. |
| Eckerwal GE. [85] | 2006 | RCT | Standard formula by NG tube feeding vs. total parenteral nutrition | Standard formula can also be administered by NG route. |
| Petrov MS. [105] | 2009 | SR and MA | Standard formula vs. semi-elemental formula. | The use of polymeric formulation is not associated with a significantly higher risk of feeding intolerance, infectious complications, or mortality rate. |
| Endo A. [111] | 2008 | RCS | Elemental formula vs. semi-elemental formula and standard formula. | No clinical advantages of the elemental formula in comparison with other formulae in terms of risk of sepsis, hospital-free days, total healthcare costs, and in-hospital mortality. |
CT: clinical trial, MA: meta-analysis, NG: nasogastric, NJ: nasojejunal, RCT: randomized controlled trial, RCS: retrospective cohort study, SAP: severe acute pancreatitis, SR: systematic review.