Table 3.

Summary of nutrition management in severe acute pancreatitis and areas for future research

Recommendation	Areas for future research
Energy requirement should be measured by IC, or 25 kcal/kg/d may be used	Role of on-demand oral diet
Protein requirements are 1.2-1.5 g/kg/d	Polymeric formula vs elemental/semi- elemental formula
Early EN within 48 h is recommended	Timing and benefits of PN in intestinal failure type I or II
Gastric or Jejunal feeding is acceptable	Role of enteral glutamine, probiotics, omega-3 FAs, antioxidants
Intravenous glutamine may be considered in patients with TPN
PEI should be monitored, especially in alcoholic, severe, and necrotizing pancreatitis

EN: Enteral nutrition; IC: Indirect calorimetry; TPN: Total parenteral nutrition; PEI: Pancreatic exocrine insufficiency; FAs: Fatty acids.