Acute pancreatitis (AP) is one of the most common diseases in routine clinical practice of surgeons and gastroenterologists throughout the world. The high rate of pain relapse after oral refeeding contributes to high consumption of healthcare resources and prolonged hospital stay in AP patients. The data from the pilot MIMOSA trial suggest that early administration of nasogastric tube feeding may prevent pain relapse after oral refeeding in AP. The potential beneficial effects of enteral tube feeding include induction of postprandial gastrointestinal motility and improving the tolerance of oral refeeding. This may reduce the risk of pain relapse, thereby shortening length of hospital stay and reducing cost of treatment. The primary endpoint of the ORION trial will be the incidence of oral food intolerance. All eligible AP patients will be randomly allocated to either the Early Nasogastric Tube (ENT) group or Conventional Nutritional Management group (CNM) at 24h of hospital admission.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
A nasogastric tube will be placed into the stomach of patients.
Patients who are to have CNM will be on nil-by-mouth regimen until they either develop signs of severe AP (in which case nasojejunal tube feeding will be introduced) or the signs of AP mitigate (in which case clear liquids (as tolerated) followed by oral food (as tolerated) will be introduced)
University of Auckland
Auckland, New Zealand
Incidence of oral food intolerance
Time frame: Participants will be followed for the duration of hospital stay, an expected average of 3 weeks
Progression of severity
Time frame: Participants will be followed for the duration of hospital stay, an expected average of 3 weeks
Pain relapse
Time frame: Participants will be followed for the duration of hospital stay, an expected average of 3 weeks
Use of opioids
Time frame: Participants will be followed for the duration of hospital stay, an expected average of 3 weeks
Duration of hospital stay
Time frame: Participants will be followed for the duration of hospital stay, an expected average of 3 weeks
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