Effects of Delayed Enteral Nutrition on Inflammatory Responses and Immune Function Competence in Critically Ill Patients With Prolonged Fasting
Severe Acute Pancreatitis Patients, Duodenal Fistula, Inflammatory Intestinal Obstruction
About this trial
This is an interventional treatment trial for Severe Acute Pancreatitis Patients
Eligibility Criteria
Inclusion Criteria:
- having a fasting time of more than 14 days
- American Society of Anesthesiologists (ASA) physical status ranging between 1 and 3, and their condition allows enteral nutrition therapy.
Exclusion Criteria:
- chronic renal failure (peritoneal or hemodialysis or creatinine > 2.5 mg/dl)
- history of chronic obstructive pulmonary disease
- hepatic dysfunction or cirrhosis or a bilirubin value > 3 mg/dl
- metabolic diseases,severe anemia
- blood coagulation dysfunction
- pregnancy lactation
- history of psychiatric illness
- patients underwent immunosuppressive therapy
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
EN group
parenteral nutrient group
The EN group gradually restored enteral nutrition, while the PN group continued to receive parenteral nutrition treatment. Both groups received between 20 to 25 kcal/kg/day and 1.5 g/kg/day of protein. Because of the low volume, concentration, and calorie amount, on the first day, tube feeding utilized 500 ml with the speed of 30 ~ 50 ml/h. On the second day, tube feeding utilized 1000 ml with the speed of 60 ~ 80 ml/h. On the third day, tube feeding utilized 1500 ~ 2000 ml with the speed of 100 ~ 120 ml/h. If enteral nutrition could not meet a patient's caloric requirements, PN supplement was started on the fourth day. The required calories and protein for each individual in the two groups was assumed to be achieved after three days of therapy. The PN group continued to receive parenteral nutrition.