When to Initialize Enteral Nutrition in Patients With Severe Acute Pancreatitis?

OBJECTIVE: The present retrospective study aimed to analyze the optimal time to initiate enteral nutrition (EN) in patients with severe acute pancreatitis at a single Chinese institution (China Medical University Hospital). METHODS: A total of 1196 patients with severe acute pancreatitis were admitted in the intensive care unit between November 2003 and June 2013; 1092 patients were selected and were divided into the early and delayed EN groups, according to their initial timing of EN. RESULTS: Five hundred sixty-six patients were administered with the delayed EN, and 526 with the early EN. Both groups had similar severity of pancreatic necrosis, but organ failure developed in 81% patients of the delayed EN group and 21% in the early EN group (P < 0.01). The numbers of septic necrosis and morbidity were significantly higher in the delayed EN group than in the early EN (P < 0.01). CONCLUSIONS: The early EN had significant benefits over the delayed EN in the decrease of organ failure and mortality; our findings suggested that the first 48 hours of administration in the intensive care unit was the optimal time to start EN.