Nutrition support is required to prevent or reverse malnutrition in the 15%–20% of patients that develop severe or complicated pancreatitis who are unable to resume oral intake in seven-to-ten days. The best available data supports the use of jejunal feeding over parenteral nutrition in those patients. Jejunal enteral nutrition can be successfully achieved by using nasojejunal access (in those ...

OBJECTIVE An overzealous inflammatory response is an important cause of morbidity and mortality in surgical, trauma, and critically ill patients. Enteral administration of lipid-rich nutrition was previously shown to attenuate inflammation and reduce organ damage via a cholecystokinin-1 receptor-mediated vagovagal reflex in animal studies. The current preclinical study investigates the immunomo...

Early postoperative nutrition improves outcomes. However, postoperative fasting is a tradition that persists in some areas of surgical practice. This retrospective audit was performed to benchmark current nutrition support practices on a mixed specialty surgical ward in a large tertiary-referral teaching hospital. Thirty-eight consecutive patients, who were undergoing gynaecological or urologic...

Metabolic changes that occur in acute pancreatitis result, as with other critically ill patients, in a metabolic stress situation that many times requires the application of a specialized nutritional support. Patients presenting the highest severity indexes (defined as Ranson's index = 3 or an APACHE II = 10) are candidates to receive nutritional support. Enteral nutrition must be the first rou...

To compare the short-term outcomes between hepatocellular carcinoma (HCC) patients with and those without preoperative nutrition on the basis of postoperative enteral nutrition.HCC patients with postoperative enteral nutrition who underwent liver resection between February 2010 and December 2014 in Nanjing Drum Tower Hospital were considered for the study: 43 patients with and 36 patients witho...

Nutritional support of surgical and critically ill patients has undergone significant advances since 1936 when Studley demonstrated a direct relationship between pre-operative weight loss and operative mortality. The advent of total parenteral nutrition followed by the extraordinary progress in parenteral and enteral feedings, in addition to the increased knowledge of cellular biology and bioch...

Recent studies challenge the beneficial role of artificial nutrition provided to critically ill patients and point out the limitations of existing studies in this area. We take a differing view of the existing data and refute many of the arguments put forward by previous authors. We review the mechanistic, observational, and experimental data supporting a role for early enteral nutrition in the...

The pancreas plays a major role in nutrient digestion. Therefore, in both acute and chronic pancreatitis, exocrine and endocrine pancreatic insufficiency can develop, impairing digestive and absorptive processes. These changes can lead to malnutrition over time. In parallel to these changes, decreased caloric intake and increased metabolic activity are often present. Nutritional deficiencies ne...

2015 Recommendation: Based on 1 level 1 study, 3 level 2 studies and 2 cluster randomized controlled trials, when starting enteral nutrition in critically ill patients, strategies to optimize delivery of nutrients (starting at target rate, volume-based feeding strategies, higher threshold of gastric residual volumes, use of prokinetics, concentrated feeding solutions and small bowel feedings) s...

Pediatric patients require specialized attention and have diverse demands for proper growth and development, and thus need a different approach and interest in nutritional assessment and supply. Enteral nutrition is the most basic and important method of nutritional intervention, and its indications should be identified. Also, the sites, modes, types, and timing of nutritional intervention acco...