Nasogastric or nasointestinal feeding in severe acute pancreatitis

Table 1 Characteristics of the 116 patients with acute pancreatitis hospitalized in the study period n (%)

Gender (female/male)	53/63
Median age (range, yr)	55.5 (17-92)
Mild/severe pancreatitis	88/28
Etiology
Biliary	59 (50.9)
Alcoholic	28 (24.1)
Drug-induced	4 (3.4)
Idiopathic	8 (6.9)
Hypertrigliceridemia	3 (2.6)
Iatrogenic	6 (5.2)
Autoimmune	1 (0.9)
Traumatic	1 (0.9)
Pancreas divisum	4 (3.4)
Intrapapillary mucinous tumour	2 (1.7)

Table 2 Demographics and clinical features of the 25 patients with predicted severe acute pancreatitis who received enteral nutrition, according to tube position at nutrition start

	Nasogastric (n = 15)	Nasointestinal (n = 10)	P
Sex (female, %)	6 (40)	4 (40)	1
Median age (yr)	56 (31-83)	63 (36-89)	0.3
BMI (kg/m2)	24.8 (21.4-28.2)	25.4 (21.8-29.1)	0.7
Amylase at entry (U/L; nv < 110)	1045.5 (592.2-1498.8)	1141.6 (127.7-2155.4)	0.8
Lipase at entry (U/L; nv < 300)	8559.8 (3676.4-13 443.2)	14 037 (2026.1-30 100.1)	0.4
CT severity index	6.2 (5.1-7.2)	4.7 (3.5-5.8)	0.04
Ranson’s score	3.8 (3.1-4.6)	3 (1.6-4.3)	0.2
CRP at 72 h (mg/L)	149.1 (82.5-215.6)	138 (27-249)	0.8
White blood dells count at entry	13 620 (10 476-16 760)	9940 (5200-14 675)	0.1
LDH at entry (mU/mL)	841.8 (608.8-1074.7)	862.6 (244.8-1480.4)	0.9
Hematocrit at entry (%)	38.6 (33.9-43.2)	39.6 (35.9-43.2)	0.7
Etiology: biliary/alcoholic or other	6/9	5/5	0.6

Values expressed as total number (percentage) or as mean (95% CI), but for age. BMI: Body mass index; CT: Computerized tomography; CRP: C reactive protein; LDH: Lactate dehydrogenase.

Table 3 Tolerability and success of nutrition according to tube position n (%)

	Nasogastric (n = 15)	Nasointestinal (n = 10)	P
Tube malpositioning	0	0	-
Epistaxis or Sinusitis	1 (6.6)	1 (10)	1
Accidental tube removal	0	1 (10)	0.4
Tube clogging	1 (6.6)	0	1
Aspiration pneumonia	0	0	-
Exacerbation of pain	5 (33.3)	2 (20)	0.68
Vomiting	2 (13.3)	1 (10)	1
Diarrhoea	5 (33.3)	3 (30)	1
Amylase increase > 10%	0	0	-
Lipase increase > 10%	1 (6.6)	0	1
CRP increase > 10%	2 (13.3)	2 (20)	1
Need to switch to TPN	4 (26.6)	0	0.27
Energetic target reached	14 (93.3)	8 (80)	1
Days to caloric target, mean (95% CI)	5.6 (3.8-7.4)	4.3 (3.1-5.6)	0.3

TPN: Total parenteral nutrition.

Table 4 Clinical outcomes of patients according to tube position n (%)

	Nasogastric (n = 15)	Nasointestinal (n = 10)	P
Mortality	0	0	-
Need of surgery	0	0	-
Complications
Infected pancreatic necrosis	3 (20)	1 (10)	1
Renal failure	1 (6.6)	0	1
Respiratory failure	2 (13.3)	0	0.1
Bleeding	1 (6.6)	0	1
Any of the above complications	4 (26.6)	1 (10)	0.6
Total hospital stay,mean (95% CI)	30.6 (18.1-43)	21.2 (17.7-24.6)	0.1