A Meta Analysis Of Enteral Nutrition For Severe Acute Pancreatitis Within 48 Hours After Admission

Objective There is still Controversy about whether enteral nutrition(EN)is administereed to patients with severe acute pancreatitis(SAP)during the periods of intestinal stress or during periods of intestinal stress or during remission.This study was aimed to evaluate the efficacy and safety of EN within 48 hours after admission in the patients with SAP.Methods PubMed、EMbase、The Cochrane Library、CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials(RCTs)on early EN(starting within 48 hours after admission)in SAP from inception to October,2018.Data extraction and quality evaluation were conducted by two evaluators.Statistical analysis was carried out using Stata 12.0 software.Results A total of 9 RCTs involving 1074 patients were included.The results of this meta-analysis showed that:compared to patients with EN after 48 hours or PN,the patients given EN within 48 hours after admission,the combined risk ratios was(RR=0.53,95%CI:0.29 to0.96,I~2=36.6%,P=0.036)for mortality,(RR=0.58,95%CI:0.44 to 0.77,I~2=0%,P<0.001)for MODS,RR=1.00,95%CI:0.86 to1.16,I~2=18.1%,P=1.00)for SIRS.The recommended grade of evidence quality is highly recommended.Conclusions EN within 48 hours after admission can reduce the mortality and morbidity of MODS in SAP patients.