Peculiarities of nasogastric and nasojejunal feeding during the early period of acute severe pancreatitis
The OBJECTIVE of the study was to identify factors independently influencing intolerance to early enteral feeding via a nasogastric and nasojejunal tube in patients during the early phase of severe acute pancreatitis.METHODS AND MATERIALS. An open, randomized, controlled, cohort study was carried ou...
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Pavlov First Saint Petersburg State Medical University
2022-05-01
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| Series: | Вестник хирургии имени И.И. Грекова |
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| Online Access: | https://www.vestnik-grekova.ru/jour/article/view/1856 |
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| author | O. G. Sivkov A. O. Sivkov I. B. Popov E. U. Zaitsev |
| author_facet | O. G. Sivkov A. O. Sivkov I. B. Popov E. U. Zaitsev |
| author_sort | O. G. Sivkov |
| collection | DOAJ |
| description | The OBJECTIVE of the study was to identify factors independently influencing intolerance to early enteral feeding via a nasogastric and nasojejunal tube in patients during the early phase of severe acute pancreatitis.METHODS AND MATERIALS. An open, randomized, controlled, cohort study was carried out. Out of 64 patients with predictors of severe acute pancreatitis, a cohort with severe form was isolated, in which 16 patients received nasogastric and 15 patients – nasojejunal feeding. The enteral feeding intolerance criteria were: discharge via the nasogastric tube >500ml at a time or >500ml/day compared to total enteral feeding administered during 24 hours, intensified pain syndrome, abdominal distension, diarrhea, nausea and vomiting. Indicators featuring prognostic significance were identified using the logistic regression technique. The null hypothesis was rejected at p<0.05.RESULTS. The presented findings demonstrate that a more severe multiple organ failure (SOFA – OR – 1.283, 95 % CI 1.029–1.6, p=0.027), the operative day (OR – 4.177, 95 % CI 1.542–11.313, p=0.005) increase while the nasojejunal route of nutrients delivery decreases (OR – 0.193, 95 % CI 0.08–0.4591, p≤0.001) the incidence of large residual stomach volumes. Postpyloric feeding reduces the risk of developing pain syndrome (OR – 0.191, 95 % CI 0.088–0.413, p≤0.001), abdominal distension (OR – 0.420, 95 % CI 0.203–0.870, p=0.002), nausea and vomiting (OR – 0.160, 95 % CI 0.069–0.375, p≤0.001).CONCLUSION. During severe acute pancreatitis, multiple organ dysfunction, the nasogastric route of enteral feeding delivery, and the fact of a surgery increase independently the risk of developing large residual stomach volumes. In case of severe acute pancreatitis, the nasogastric route of nutrients administration increases the development of such manifestations of enteral feeding intolerance as nausea, vomiting, pain intensification, and abdominal distension. In patients with severe acute pancreatitis, the nasoejunal route of administration of nutrients is preferable. |
| format | Article |
| id | doaj-art-e3cb4cc0a78a4501983b35cd7a65aab4 |
| institution | DOAJ |
| issn | 0042-4625 |
| language | Russian |
| publishDate | 2022-05-01 |
| publisher | Pavlov First Saint Petersburg State Medical University |
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| series | Вестник хирургии имени И.И. Грекова |
| spelling | doaj-art-e3cb4cc0a78a4501983b35cd7a65aab42025-08-20T03:02:28ZrusPavlov First Saint Petersburg State Medical UniversityВестник хирургии имени И.И. Грекова0042-46252022-05-011806566110.24884/0042-4625-2021-180-6-56-611349Peculiarities of nasogastric and nasojejunal feeding during the early period of acute severe pancreatitisO. G. Sivkov0A. O. Sivkov1I. B. Popov2E. U. Zaitsev3Tyumen Cardiology Research CenterMedical and Sanitary Unit “Neftyanik”Medical and Sanitary Unit “Neftyanik”Medical and Sanitary Unit “Neftyanik”The OBJECTIVE of the study was to identify factors independently influencing intolerance to early enteral feeding via a nasogastric and nasojejunal tube in patients during the early phase of severe acute pancreatitis.METHODS AND MATERIALS. An open, randomized, controlled, cohort study was carried out. Out of 64 patients with predictors of severe acute pancreatitis, a cohort with severe form was isolated, in which 16 patients received nasogastric and 15 patients – nasojejunal feeding. The enteral feeding intolerance criteria were: discharge via the nasogastric tube >500ml at a time or >500ml/day compared to total enteral feeding administered during 24 hours, intensified pain syndrome, abdominal distension, diarrhea, nausea and vomiting. Indicators featuring prognostic significance were identified using the logistic regression technique. The null hypothesis was rejected at p<0.05.RESULTS. The presented findings demonstrate that a more severe multiple organ failure (SOFA – OR – 1.283, 95 % CI 1.029–1.6, p=0.027), the operative day (OR – 4.177, 95 % CI 1.542–11.313, p=0.005) increase while the nasojejunal route of nutrients delivery decreases (OR – 0.193, 95 % CI 0.08–0.4591, p≤0.001) the incidence of large residual stomach volumes. Postpyloric feeding reduces the risk of developing pain syndrome (OR – 0.191, 95 % CI 0.088–0.413, p≤0.001), abdominal distension (OR – 0.420, 95 % CI 0.203–0.870, p=0.002), nausea and vomiting (OR – 0.160, 95 % CI 0.069–0.375, p≤0.001).CONCLUSION. During severe acute pancreatitis, multiple organ dysfunction, the nasogastric route of enteral feeding delivery, and the fact of a surgery increase independently the risk of developing large residual stomach volumes. In case of severe acute pancreatitis, the nasogastric route of nutrients administration increases the development of such manifestations of enteral feeding intolerance as nausea, vomiting, pain intensification, and abdominal distension. In patients with severe acute pancreatitis, the nasoejunal route of administration of nutrients is preferable.https://www.vestnik-grekova.ru/jour/article/view/1856acute pancreatitisartificial tube feedingnasogastric and nasojejunal tubesintoleranceresidual volume stomachnauseavomitingabdominal distention |
| spellingShingle | O. G. Sivkov A. O. Sivkov I. B. Popov E. U. Zaitsev Peculiarities of nasogastric and nasojejunal feeding during the early period of acute severe pancreatitis Вестник хирургии имени И.И. Грекова acute pancreatitis artificial tube feeding nasogastric and nasojejunal tubes intolerance residual volume stomach nausea vomiting abdominal distention |
| title | Peculiarities of nasogastric and nasojejunal feeding during the early period of acute severe pancreatitis |
| title_full | Peculiarities of nasogastric and nasojejunal feeding during the early period of acute severe pancreatitis |
| title_fullStr | Peculiarities of nasogastric and nasojejunal feeding during the early period of acute severe pancreatitis |
| title_full_unstemmed | Peculiarities of nasogastric and nasojejunal feeding during the early period of acute severe pancreatitis |
| title_short | Peculiarities of nasogastric and nasojejunal feeding during the early period of acute severe pancreatitis |
| title_sort | peculiarities of nasogastric and nasojejunal feeding during the early period of acute severe pancreatitis |
| topic | acute pancreatitis artificial tube feeding nasogastric and nasojejunal tubes intolerance residual volume stomach nausea vomiting abdominal distention |
| url | https://www.vestnik-grekova.ru/jour/article/view/1856 |
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