The Effects of Pancreatic Enzyme Supplementation in Critically Ill Patients on Enteral Feeding

Inclusion Criteria: * Adults 19 years and older * Hospitalized in the surgical/medical intensive care unit of the Seoul National University Hospital * Enteral nutrition * Patients who consented to this study * Patients with risk factors for pancreatic exocrine dysfunction * Shock (Norepinephrine) * Sepsis (3 rd definition of sepsis) * Diabetes * Cardiac arrest * hyperlactatemia serum lactate \> 2 mmol/L) * Mechanical ventilation * Continuous renal replacement therapy Exclusion Criteria: * chronic pancreatitis * unresectable pancreatic cancer * History of pancreatectomy * Underlying diseases in which the effect of Exocrine pancreatic enzyme administration is difficult to show * Inflammatory bowel disease * Short bowel syndrome