Enteral nutrition, when compared with no supplementary nutrition, was associated with no significant change in infectious complications: ratio of relative risks (RR) 0.56, 95% confidence interval (CI) 0.07–4.32, P=0.58, but a significant reduction in mortality: ratio of RR 0.22, 95% CI 0.07–0.70, P=0.01. Parenteral nutrition, when compared with no supplementary nutrition, was associated with no significant change in infectious complications: RR 1.36, 95% CI 0.18–10.40; P=0.77, but a significant reduction in mortality: RR 0.36, 95% CI 0.13–0.97, P=0.04. Enteral nutrition, when compared with parenteral nutrition, was associated with a significant reduction in infectious complications: RR 0.41, 95% CI 0.30–0.57, P less than 0.001, but no significant change in mortality: RR 0.60, 95% CI 0.32–1.14, P=0.12.
So enteral nutritional appears to be the way to go. What the paper (or at least the abstract) doesn't tell us is how soon to start, whether jejunal feedings are better, and the severity of pancreatitis as an indication for nutritional support.
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