EVALUATION OF THE EFFICIENCY OF NASOGASTRAL NUTRITION IN PATIENTS WITH SEVERE ACUTE PANCREATITIS

Abstract

Relevance. Early onset of enteral nutrition (up to 48 hours after hospitalization) in patients with severe acute pancreatitis is associated with a 24% reduction in infectious complications and a 32% reduction in mortality. Data on the possibility of nasogastric tube feeding remain contradictory. Objective: comparison of the effectiveness and safety of nasogastric administration of food mixtures in patients with severe acute pancreatitis. Methods. The study included 103 patients with severe acute pancreatitis, which were divided depending on the characteristics of the chosen treatment tactics into three groups: based group (nasogastric nutrition was performed) - 34 patients, comparison group #1 (standard enteral nutrition) - 33 patients and comparison group #2 (parenteral nutrition) - 36 patients. To analyze the effectiveness of nutritional support in the study groups after 7 and 14 days from the beginning of treatment, the level of laboratory parameters was assessed, the incidence of local complications, mortality, duration of multiorgan failure and hospital stay were analyzed. Results. After 7 and 14 days of nutritional support, a significant difference was found between total protein, albumin, creatinine, urea, cholesterol, glucose and serum Na + (p<0.05) between patients in the main group and comparison group #2, with the level of cholesterol, K + and Na + corresponded to the norm in both groups. There was also a significant difference in the incidence of infected local complications of severe acute pancreatitis in the main group and comparison group #2 - 35.3% and 61.1%, respectively (χ2=4.59, 95% CI 2.43-45.53, p=0.03), duration of multiorgan failure - 12.2±1.7 [8-16] days and 15.3±1.1 [13-18] days, respectively (p<0.001), duration of hospital stay - 55.5±30.5 [27-124] days and 71.5±35.9 [35-148] days, respectively (p=0.04) and fatalities - 14.7% and 36.1%, respectively (χ2=4.13, 95 % CI 0.81-39.68, p=0.04). When comparing these indicators between the main group and the comparison group #1 no significant difference was obtained (p>0.05). Conclusions. Nasogastric nutrition is an effective and safe method of administration of mixtures in patients with severe acute pancreatitis and can be considered as an alternative to enteral nutrition.