Influence of enteral versus parenteral nutrition on blood glucose control in acute pancreatitis

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Clin Nutr. 2007 Jun 6; [Epub ahead of print]

Influence of enteral versus parenteral nutrition on blood glucose

control in acute pancreatitis: A systematic review.

Petrov MS, Zagainov VE.

Department of Surgery, Nizhny Novgorod State Medical Academy, PO

Box 568, Nizhny Novgorod, 603000 Russia.

BACKGROUND & AIMS: There is increasing evidence that tight glucose

control may reduce infectious complications and mortality in surgical

critically ill patients. However, data regarding the influence of

artificial nutrition on glycemic homeostasis are limited. Our aim was to

review all randomized controlled trials on enteral versus parenteral

nutrition in acute pancreatitis to determine whether the route of

feeding can affect the glucose control in the setting of this disease.

METHODS: Relevant literature cited in three electronic databases

(Cochrane Central Register of Controlled Trials, EMBASE and Medline)

were systematically reviewed. A meta-analysis was carried out using a

random-effects model. RESULTS: Thirteen randomized controlled trials on

enteral versus parenteral nutrition in acute pancreatitis were

identified. Seven studies were excluded from analysis, leaving 6 trials

in which a total of 264 non-diabetic patients with acute pancreatitis

were treated. Intake of nutrients did not differ among enterally and

parenterally fed patients in 5 of 6 randomized controlled trials.

Enteral nutrition reduced the risk of hyperglycemia (relative risk 0.53;

95% confidence interval 0.29-0.98; p=0.04) and insulin requirement

(relative risk 0.41; 95% confidence interval 0.24-0.70; p=0.001).

CONCLUSIONS: Enteral nutrition, when compared with parenteral nutrition,

is associated with better blood glucose control in patients with acute

pancreatitis.

PMID: 17559987 [PubMed - as supplied by publisher]

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