METABOLIC DISORDERS CAUSED BY ACUTE PANCREATITIS AND WAYS OF THEIR CORRECTION USING ENTERAL NUTRITION OF PATIENTS
I.V. Kolosovych, I.V. Hanol
Bogomolets National Medical University, Department of
Surgery No. 2, Kyiv, Ukrainе
DOI: https://doi.org/10.15407/fz69.04.092
Abstract
The occurrence of hypermetabolism and hypercatabolism
syndromes in patients with acute pancreatitis is associated with
the release of pro-inflammatory cytokines, which leads to an
increase in energy consumption and basic metabolism, which
depend on both the severity of the course and the duration of
the disease. The aim of our work was to investigate the state
of the problem of nutritional support for patients with acute
pancreatitis at the current stage. The degree of nutritional
status disorders in patients with acute pancreatitis varies
depending on the etiological factors and severity of the disease
and requires a differentiated approach to their correction.
With the development of hypermetabolic syndrome, energy
consumption can increase by 77-158%. Nutritional support is
an important component of acute pancreatitis therapy, the goal
of which is to ensure adequate caloric intake, modulate the
response to oxidative stress, and counteract catabolic effects
during the course of the disease. Restoration of intestinal
absorption in patients with severe acute pancreatitis occurs on
average 48 h after the start of complex conservative therapy,
which is the optimal time to start enteral nutrition. Nasogastric
nutritional support in patients with severe acute pancreatitis is
safe and leads to a 25.8% reduction in the incidence of local
infectious complications, length of hospital stay by 16 days
and deaths by 21.4% in comparison with parenteral nutrition.
The use of antiflatulents as part of a mixture for enteral
nutrition allows to improve the laboratory indicators of blood
serum, to reduce the frequency of intestinal complications by
21.5%. Nutritional support should be started with nasogastric
administration of food mixture, and in case of complications
(intolerance, aspiration, etc.), nasojejunal administration.
Parenteral nutrition should be used if enteral nutrition is
impossible or not tolerated.
Keywords:
acute pancreatitis; metabolic disorders; nutritional support; complications
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