Nutritional Support of Patients With the Abdominal Compartment Syndrome During Severe Acute Pancreatitis.
There is growing evidence in the literature that development of Abdominal Compartment Syndrome in patients with Severe Acute Pancreatitis has a strong impact on the course of disease. Incidence of ACS in patients with SAP is around 20%. The mortality rate in patients who developed ACS during SAP is 49%, while it is 11% in patients without this complication.
The development of organ failure in SAP is in correlation with the presence of intra-abdominal hypertension which can deteriorate already compromised pancreatic perfusion and perfusion of gut in early stages of SAP. The latter leads to the alteration of gut functioning with consequent reduced possibility for enteral feeding. Enteral Nutrition facilitates gut motility and alleviates bacterial translocation, but in patients suffering from ACS during course of SAP could aggravate bowel ischemia.
Parenteral nutrition is required as nutritional support in ACS, but it may increase bacterial translocation and deteriorate gut functioning. Since in the literature data there still have not had recommendations regarding nutritional support of patients with ACS during course of SAP, including optimal time for initiation, duration and amount of specific nutritional regiment, in this short review we have tried to give insight into problems in nutritional support in those patients. This should fortify the interest of physicians to make additional research in order to support further strategies for the more optimal nutritional support of patients with this lethal complication.
Pancreas Open J. 2016; 1(1): 14-18. doi: 10.17140/POJ-1-105