Determination of Time Interval between Hospitalization and Establishment of Naso Jejunal Feeds in Acute Pancreatitis- A Western Indian Study

Abstract

Acute Pancreatitis (AP) is characterized by diffuse inflammatory process of pancreas with variable involvement of adjacent tissues and dysfunction of remote organs. Mortality rate in patients with AP is reported in the range of 9%-27% with two peaks. Nutritional support is one of the key factors in improving outcomes in cases of AP as per the current guidelines. Several clinical studies and meta- analysis regarding the effectiveness of enteral nutrition conclude that enteral nutrition through nasojejunal route is safe and can preserve the integrity of intestinal mucosa to decrease the incidence of infectious complications and other severe complications as well as resulted in better control of blood glucose levels. Enteral nutrition as early as within 24 hours or 48 hours has been recommended in various clinical studies. Though early enteral nutrition has been shown to reduce infectious complications in western literature, in clinical practice, it is not always possible to institute feeds so early. There can be delay due to factors like patient factors and extrinsic factors. While patient factors can include prolonged ileus, patients with altered mental condition patients on ventilatory support etc, extrinsic factors can be non- working of machine, other logistical problems and non-tolerance of feeds. We intended to determine the average time interval between the hospitalization of patients and establishment of feeds in our patients of AP. This was an open label longitudinal study conducted in a single surgical unit at a tertiary referral hospital in Mumbai. The sample size was 61 and study was conducted for a period of 6 months. For statistical analysis, descriptive statistics was used. To find average time, arithmetic mean was used. The average time interval is found to be 4.6 days.