Effects Of Early Enteral Nutrition On Intra-abdominal Pressure In Severe Acute Pancreatitis:A

Objective The aim of this study was to investigate the effects of early enteral nutrition on intra-abdominal pressure in patients with severe acute pancreatitis, as well as the effects of different intra-abdominal pressure values on the incidence of feeding intolerance.Methods All the patients enrolled in this study were randomly allocated to receive either early enteral nutrition or delayed enteral nutrition by computer-generated random numbers on admission. Enteral feeding was started within the first48-hour after admission in group of early enteral nutrition, whereas on the8th day in group of delayed enteral nutrition. The values of intra-abdominal pressure were recorded per6-hour and continued for2weeks. The number of patients with feeding intolerance was recorded daily after enteral feeding was started. The markers of intestinal mucosal barrier, nutrition, immunity and disease severity were measured on the first and third day after admission, and were repeated on the7th and14th day.Results A total of60patients with severe acute pancreatitis were enrolled in this randomized clinical trial from September2010to September2011. The values of intra-abdominal pressure in early enteral nutrition group were lower than that in delayed enteral nutrition group from the14th day. Moreover, the decreased tendency of intra-abdominal hypertension incidence between the two groups was significantly different at the7th day after admission. Patients with pressure<15mmHg had lower feeding intolerance incidence than those with pressure≥15mmHg. The pre-albumin levels, the markers of intestinal mucosal barrier, immunity and disease severity between the two groups were significantly different from the7th day after admission.Conclusions Early enteral nutrition had an earlier tendency to decrease intra-abdominal pressure as well as to reduce the intra-abdominal hypertension incidence of SAP. Enteral feeding might be performed well when the pressure was less than15mmHg. Early enteral nutrition had the ability to maintain the integrity of intestinal mucosal barrier, to improve the immune function and the disease severity of severe acute pancreatitis.