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Restoration of energy level in the early phase of acute pediatric pancreatitis

World Journal of Gastroenterology 2017年第6期23卷 957-963页

作者： Dóra Mosztbacher nelli Farkas Margit Solymár Gabriella Pár Judit Bajor ákos Szucs József Czimmer Katalin Márta Alexandra Mikó zoltán rumbus Péter Varjú Péter Hegyi Andrea Párniczky First Department of Pediatrics Semmelweis University Institute for Translational Medicine University of Pécs Institute for Bioanalyses University of Pécs Department of Gastroenterology First Department of MedicineUniversity of Pécs Department of Translational Medicine First Department of MedicineUniversity of Pécs First Department of Surgery Semmelweis University Hungarian Academy of Sciences-University of Szeged Momentum Gastroenterology Multidisciplinary Research Group Heim Pál Children’s Hospital

Acute pancreatitis (AP) is a serious inflammatory disease with rising incidence both in the adult and pediatric populations. It has been shown that mitochondrial injury and energy depletion are the earliest intracellular events in the early phase of AP. Moreover, it has been revealed that restoration of intracellular ATP level restores cellular functions and defends the cells from death. We have recently shown in a systematic review and meta-analysis that early enteral feeding is beneficial in adults; however, no reviews are available concerning the effect of early enteral feeding in pediatric AP. In this minireview, our aim was to systematically analyse the literature on the treatmentof acute pediatric pancreatitis. The preferred reporting items for systematic review(PRISMA-P) were followed, and the question was drafted based on participants, intervention, comparison and outcomes: P: patients under the age of twenty-one suffering from acute pancreatitis; I: early enteral nutrition (per os and nasogastric- or nasojejunal tube started within 48 h); C: nil per os therapy; O: length of hospitalization, need for treatment at an intensive care unit, development of severe AP, lung injury (including lung oedema and pleural effusion), white blood cell count and pain score on admission. Altogether, 632 articles (Pub Med: 131; EMBASE: 501) were found. After detailed screening of eligible papers, five of them met inclusion criteria. Only retrospective clinical trials were available. Due to insufficient information from the authors, it was only possible to address length of hospitalization as an outcome of the study. Our mini-meta-analysis showed that early enteral nutrition significantly(SD = 0.806, P = 0.034) decreases length of hospitalization compared with nil per os diet in acute pediatric pancreatitis. In this minireview, we clearly show that early enteral nutrition, started within 24-48 h, is beneficial in acute pediatric pancreatitis. Prospective studies and better pres

关键词： pediatric pancreatitis enteral nutrition nil per os diet ATP restoration length of hospitalization

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