Early enteral feeding in severe acute pancreatitis: Can it prevent secondary pancreatic (super) infection?

Peter Lehocky, Michael G. Sarr

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Sepsis continues to account for a second peak in mortality in patients with severe acute pancreatitis. The prevention of these septic complications and subsequent development of multiple organ dysfunction syndrome remains a major focus for investigators, yet despite considerable clinical and experimental work addressing its etiology, septic complications remain high. Several studies have been designed to demonstrate the mechanism of origin of these septic complications with an attempt to define strategies for their prevention to improve patient outcomes. There is clear evidence that the origin of this secondary bacterial infection arises from enteric bacterial translocation secondary to disruption of the gut mucosal barrier during acute pancreatitis. Strategies designed to prevent secondary pancreatic infection include aggressive fluid resuscitation to maximize organ perfusion, early systemic antibiotic treatment or selective gut decontamination, and recently attempts to block mediators of the systemic inflammatory response. This discussion will summarize our present understanding of the etiopathogenesis of secondary bacterial 'superinfection' of necrotizing pancreatitis and how the initiation of enteral feeding early in the course of acute pancreatitis may prove to be an effective means of preventing and/or reversing the breakdown of the gut mucosal defense barrier.

Original languageEnglish (US)
Pages (from-to)571-577
Number of pages7
JournalDigestive Surgery
Volume17
Issue number6
DOIs
StatePublished - 2000

Fingerprint

Enteral Nutrition
Pancreatitis
Infection
Coinfection
Bacterial Translocation
Superinfection
Decontamination
Multiple Organ Failure
Bacterial Infections
Resuscitation
Sepsis
Perfusion
Research Personnel
Anti-Bacterial Agents
Mortality
Therapeutics

Keywords

  • Acute pancreatitis
  • Bacterial translocation
  • Endotoxin
  • Enteral feeding
  • Gut
  • Infected pancreatic necrosis
  • Necrotizing pancreatitis
  • Sepsis

ASJC Scopus subject areas

  • Surgery

Cite this

Early enteral feeding in severe acute pancreatitis : Can it prevent secondary pancreatic (super) infection? / Lehocky, Peter; Sarr, Michael G.

In: Digestive Surgery, Vol. 17, No. 6, 2000, p. 571-577.

Research output: Contribution to journalArticle

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