Sequential nutrition support with the combination of parenteral and enteral nutrition in the management of severe acute pancreatitis

Background: Severe acute pancreatitis (SAP) patients are in a highly catabolic state, and reasonable nutritional support is important in improving prognosis. This retrospective study was designed to assess the efficacy of combined sequential therapy of total parenteral nutrition with enteral nutrition (TPN-EN) in the management of SAP patients. Methods: The clinical data (including recovery time, APACHE II score, and hematological indicators) of 39 SAP patients who had received TPN-EN in our center in the past 6 years were retrospectively analyzed. Furthermore, the results were compared with those in 39 patients treated with total parenteral nutrition (TPN) alone (control group). Results: One week after the nutritional therapy (week 1), the APACHE II score, serum calcium, and arterial blood lactate and albumin levels were not significantly different between the TPN-EN group and the control group, and the control group had better blood glucose control. However, the APACHE II score, serum calcium, and arterial blood lactate and albumin levels in the TPN-EN group were significantly improved compared with the control group at weeks 2 and 3, and blood glucose control showed no significant difference between these two groups. Serum creatinine levels were not significantly different between these two groups throughout the treatment. Conclusions: TPN-EN can improve the prognosis of SAP patients and shorten hospital stay without increasing the visceral burdens.