Early Enteral Nutrition in Severe Acute Pancreatitis

Study Overview
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Brief Summary
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to compare different time points for enteral nutrition in SAP patients

Detailed Description
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There is increasing evidence that indicates Early Enteral Nutrition（EEN） may be associated with improved outcome in acute pancreatitis patients. However, some SAP patients failed to EEN. The researchers of this study aim to investigate the opportunity of EEN on the clinical outcomes of SAP patients.

Official Title
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Early Enteral Nutrition in Severe Acute Pancreatitis

Conditions
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Pancreatitis

Intervention / Treatment
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* Other: early enteral nutrition
* Other: modified early enteral nutrition


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of pancreatitis: Typical pain increase in serum lipase or amylase Onset of abdominal pain within <=72h before admission moderate severe or severe Acute Pancreatitis according to Atlanta criteria revisited in 2012 ffff Exclusion Criteria: 1. Pregnancy 2.tumor 3. acute onset of chronic pancreatitis chronic disease of any organ （heart lung gastrointestinal renal etc.） 5. Pre-existing disease with life expectancy < 3 months 7.receive parenteral nutrition or enteral nutrition before admitting

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: early enteral nutrition<br>Naso-gastro-jejunal tube will be set up by X-ray within 24 hours of admission. The distal end of the feeding tube would be placed at the remote end of Treitz ligament, and verified by X-ray. After catharsis, Standard enteral nutrition liquid regimen （Peptisorb Liquid）will be used step by step. Patients are targeted to receive calories for 25 kcal/kg/day. | Other: early enteral nutrition<br>* Naso-gastro-jejunal tube will be set up by X-ray within 24 hours of admission. The distal end of the feeding tube would be placed at the remote end of Treitz ligament, and verified by X-ray. • After catharsis, Standard enteral nutrition liquid regimen will be used step by step. Patients are targeted to receive calories for 25 kcal/kg/day. nutrition form: short peptide ,1 kcal/ml,target 200k kcal/day<br>|
| Active Comparator: modified early enteral nutrition<br>Naso-gastro-jejunal tube will be set up by X-ray within 24 hours of admission. The distal end of the feeding tube would be placed at the remote end of Treitz ligament, and verified by X-ray. After catharsis, Only Normal Saline were given through Naso-gastro-Jejunal tube until 2 or more followed requirements were met mean arterial pressure≥65mmHg; oxygenation index≥ 300;APCHEII≤8; intra-abdominal pressure <20mmHg).Then Standard enteral nutrition liquid regimen (Peptisorb Liquid) will be used step by step. Patients are targeted to receive calories for 25 kcal/kg/day. | Other: modified early enteral nutrition<br>* Naso-gastro-jejunal tube will be set up by X-ray within 24 hours of admission. The distal end of the feeding tube would be placed at the remote end of Treitz ligament, and verified by X-ray. After catharsis, Only Normal Saline were given through nasojejunal tube until 2 or more followed requirements were meted (mean arterial pressure≥65mmHg; oxygenation index≥ 300;APCHEII≤8; intra-abdominal pressure <20mmHg).Then Standard enteral nutrition liquid regimen (Peptisorb Liquid) will be used step by step. Patients are targeted to receive calories for 25 kcal/kg/day.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mortality | the rate of patients died | 28days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| operation rate | The rate of patients received operation for pancreatitis debridement | 2 months | 
| fulfilling enteral nutrition target（≥25Kcal/kg/day） | enteral nutrition target set as ≥25Kcal/kg/day | 7 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pancreatitis, enteral nutrition