The purpose of this prospective randomised clinical trial is to compare beneficial and harmful effects of the use enteral nutrition versus a nil-by-mouth and intravenous fluid replacement principle of treatment in patients with moderate to severe acute pancreatitis (AP). The hypothesis: * enteral nutrition is no significantly better compared with the nil-by-mouth principle regarding mortality, incidence of local and systemic complications, length of hospital stay, and intensity of the inflammatory response in patients with moderate to severe AP * enteral nutrition has the same safety as nil-by-mouth principle in patients with moderate to severe AP
Patients with first attack of AP irrespective of etiology will be enrolled in the study, if they are eligible according to the following criteria: Inclusion criteria: * onset of symptoms consistent with AP within 72 hours before admission to the hospital * an 3-fold elevation of serum amylase or serum lipase over the upper limit of normal * APACHE II score 6 or more * a signed informed consent Exclusion criteria: * patients \< 18 years of age * pregnant and breastfeeding women
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
214
Same as arm description
SIRS (Systemic Inflammatory Response Syndrome)
Time frame: 4 weeks
All-cause mortality
Time frame: 4 weeks
Organ failure (cardiovascular, respiratory, renal)
Time frame: 4 weeks
Local complications (pancreatic necrosis, fluid collections, pseudocyst, abscess)
Time frame: 4 weeks
Local septic complications
Time frame: 4 weeks
Other infections
Time frame: 4 weeks
Inflammatory response (CRP on the first and third day)
Time frame: First and third day of admission
Length of hospital stay
Time frame: 4 weeks
Adverse events
Time frame: 4 weeks
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