Nutrición en el paciente con pancreatitis aguda grave: guía de manejo clínico
DOI:
https://doi.org/10.30944/20117582.459Palabras clave:
pancreatitis, nutrición enteral, nutrición parenteral total, glutamina, arginina, probióticosResumen
Objetivo: proponer una guía de manejo para la nutrición en los pacientes con pancreatitis aguda grave basada en la mejor evidencia disponible.
Diseño: revisión sistemática y guía de práctica clínica.
Población: pacientes críticos con pancreatitis aguda grave hospitalizados en la unidad de cuidados intensivos.
Intervenciones y controles: nutrición entérica Vs. parenteral; dieta hipocalórica Vs. normocalórica; glutamina Vs. sin glutamina; arginina Vs. sin arginina; ácidos grasos omega 3/omega 6 Vs. omega 6 solamente; prebióticos o probióticos Vs. dieta estándar.
Desenlaces: mortalidad, estancia hospitalaria y en la unidad de cuidados intensivos y, infecciones y sepsis, disfunción de órganos. Materiales y métodos: búsqueda en bases de datos
médicas en línea.
Resultados: las 765 referencias iniciales fueron filtradas con las palabras clave y quedaron 69 artículos. Cinco artículos más de autores latinoamericanos o de habla hispana fueron también revisados por considerarlos pertinentes.
Conclusiones: los pacientes con pancreatitis aguda grave se benefician del soporte nutricional y la vía entérica es de elección con dietas normocalóricas de inicio temprano, preferencialmente en los primeros tres días. La intervención nutricional pudiera ser un determinante al disminuir la morbilidad y la mortalidad elevada en esta patología pero aún faltan
estudios bien diseñados que permitan determinar con claridad el efecto de cada uno de sus componentes.
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