The Correlations Between Early Enteral Nutrition and Intra-abdominal Pressure in Severe Acute Pancreatitis

NCT ID: NCT01507766

Last Updated: 2012-11-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-09-30

Study Completion Date

2011-09-30

Brief Summary

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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.

Detailed Description

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Conditions

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Acute Pancreatitis Intra-abdominal Hypertension

Keywords

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severe acute pancreatitis intra-abdominal pressure enteral nutrition

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Early enteral nutrition

The enteral nutrition was started within 48h after admission

Group Type EXPERIMENTAL

early enteral nutrition

Intervention Type DRUG

The enteral nutrition was started within 48h after admission

Delayed enteral nutrition

The enteral nutrition was started at the 8th day after admission

Group Type ACTIVE_COMPARATOR

Delayed enteral nutrition

Intervention Type DRUG

The enteral nutrition was started at the 8th day after admission

Interventions

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early enteral nutrition

The enteral nutrition was started within 48h after admission

Intervention Type DRUG

Delayed enteral nutrition

The enteral nutrition was started at the 8th day after admission

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* The diagnosis of acute pancreatitis accords with the Atlanta criteria in 1992
* Within 3 days from the onset of the disease
* Hemodynamics stable

Exclusion Criteria

* Decompressive measures and enteral nutrition was performed before admission
* Ileus of lower digestive tract
* Pregnant pancreatitis
* Chronic organs dysfunction
* Immunodeficiency
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Jinling Hospital, China

OTHER

Sponsor Role collaborator

Nanjing University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Jiakui Sun

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Wei-qin Li, M.D.

Role: STUDY_DIRECTOR

Jinlin Hospital

Locations

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Department of SICU, Research Institute of General Surgery , Jinling Hospital

Nanjing, Jiangsu, China

Site Status

Countries

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China

References

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Sun JK, Li WQ, Ke L, Tong ZH, Ni HB, Li G, Zhang LY, Nie Y, Wang XY, Ye XH, Li N, Li JS. Early enteral nutrition prevents intra-abdominal hypertension and reduces the severity of severe acute pancreatitis compared with delayed enteral nutrition: a prospective pilot study. World J Surg. 2013 Sep;37(9):2053-60. doi: 10.1007/s00268-013-2087-5.

Reference Type DERIVED
PMID: 23674254 (View on PubMed)

Sun JK, Mu XW, Li WQ, Tong ZH, Li J, Zheng SY. Effects of early enteral nutrition on immune function of severe acute pancreatitis patients. World J Gastroenterol. 2013 Feb 14;19(6):917-22. doi: 10.3748/wjg.v19.i6.917.

Reference Type DERIVED
PMID: 23431120 (View on PubMed)

Other Identifiers

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110-85

Identifier Type: -

Identifier Source: org_study_id