Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: The Correlations Between Early Enteral Nutrition and Intra-abdominal Pressure in Severe Acute Pancreatitis
Brief Summary: As an important management of severe acute pancreatitis (SAP), enteral nutrition (EN), especially early enteral nutrition (EEN) increases the blood flow of gut mucosa and stimulates the intestinal motility. Moreover, EEN maintains the gut integrity, prevents bacterial and endotoxin translocation and thereby theoretically reduces the incidence of infections. Therefore, EEN has the ability to reduce the infectious complications, length of hospital stay and mortality of patients with SAP.

However, the role of EEN is considered to be influenced by intra-abdominal hypertension (IAH) in patients with SAP. The previous studies showed that gut was the most sensitive splanchnic organ to the increase of intra-abdominal pressure (IAP). When IAH occurs, it reduces the blood flow of gut, and then results in the development of intestinal ischemia and edema. The hypoxia and hypoperfusion of intestine leads to the increase of permeability of the intestinal mucosal barrier, and then leads to bacterial translocation. Therefore, IAH could result in the gastrointestinal dysfunction. Nevertheless, the different impacts of specific IAP values on the tolerance of EEN have not been reported.

Furthermore, the effects of early enteral feeding on the IAP in SAP also remain unknown. Due to the severe inflammatory response of SAP, could EEN increase the burden of bowel, cause expansion of intestinal cavity, thus increase IAP? However, there were rare literatures up to date reporting the association between EEN and IAH in patients with SAP. Therefore, the present study aimed to investigate the influence of specific IAP on the tolerance of early enteral feeding, as well as the effects of EEN on IAP in SAP patients. Moreover, the impacts of EEN on the disease severity and clinical outcome of SAP were also researched.


Options:
A: Arm Label: 1; Type: EXPERIMENTAL; Interventions: Behavioral: Minimal (Trophic) Feeding | Arm Label: 2; Type: EXPERIMENTAL; Interventions: Behavioral: Full Feeding | Intervention Type: BEHAVIORAL; Name: Minimal (Trophic) Feeding; Assigned to Arm(s): 1 | Intervention Type: BEHAVIORAL; Name: Full Feeding; Assigned to Arm(s): 2
B: Arm Label: Early enteral nutrition; Type: EXPERIMENTAL; Interventions: Drug: early enteral nutrition | Arm Label: Delayed enteral nutrition; Type: ACTIVE_COMPARATOR; Interventions: Drug: Delayed enteral nutrition | Intervention Type: DRUG; Name: early enteral nutrition; Assigned to Arm(s): Early enteral nutrition | Intervention Type: DRUG; Name: Delayed enteral nutrition; Assigned to Arm(s): Delayed enteral nutrition
C: Arm Label: EN only; Type: EXPERIMENTAL; Interventions: Other: Withholding PN during the first week of ICU stay | Arm Label: EN plus early PN; Type: ACTIVE_COMPARATOR; Interventions: Drug: Oliclinomel N71000 OR N71000E // Clinimix N17G35 OR N17G35E | Intervention Type: OTHER; Name: Withholding PN during the first week of ICU stay; Assigned to Arm(s): EN only | Intervention Type: DRUG; Name: Oliclinomel N71000 OR N71000E // Clinimix N17G35 OR N17G35E; Assigned to Arm(s): EN plus early PN
D: Arm Label: TARGET protocol EN 1.5 kcal/mL; Type: EXPERIMENTAL; Interventions: Dietary Supplement: TARGET protocol EN 1.5 kcal/mL | Arm Label: TARGET protocol EN 1.0 kcal/mL; Type: ACTIVE_COMPARATOR; Interventions: Dietary Supplement: TARGET protocol EN 1.0 kcal/mL | Intervention Type: DIETARY_SUPPLEMENT; Name: TARGET protocol EN 1.5 kcal/mL; Assigned to Arm(s): TARGET protocol EN 1.5 kcal/mL | Intervention Type: DIETARY_SUPPLEMENT; Name: TARGET protocol EN 1.0 kcal/mL; Assigned to Arm(s): TARGET protocol EN 1.0 kcal/mL

Answer: B