HUN4446 Chronic pancreatitis

HUN4446 Chronic pancreatitis - • potential nutrition...

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parenteral nutrition (no sooner than day 5) nonfunctional GI tract necrosis no enteral access/enteral not tolerated monitor  TG blood glucose evidence for supporting early tube feeding: 50% fewer septic complications 40% fewer complications reduced length of stay lower cost improved modulation of immune response most beneficial for severe acute pancreatitis potential benefits of early jejunal TF may be due to: avoids stimulation of pancreas restoration of intestinal mucosal integrity preserves mucosal mass reduces bacterial translocation fosters more appropriate microbial environment maintains immunocompetence reduces inflammation downregulates cytokine release (empty GI tract may potentiate cytokine release) nutrition management: severe acute pancreatitis: protein: 1.5 to 2 g/kg BW kcals: indirect calorimetry (>/=kcals/kg BW)
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Unformatted text preview: • potential nutrition therapies: • arginine • glutamine • omega 3 Fas • probiotics; combination of prebiotics/probiotics • medical management: • analgesics • fluid resuscitation • h2 receptors antagonists • somatostatin • pancreatic enzyme replacement therapy ➢ chronic pancreatitis • alcoholism is most common cause • initiated by pancreatic injury • recruitment of macrophages • stellate cell stimulation • collagen formation--> fibrosis • progressive loss of pancreatic tissue • loss of exocrine/endocrine function ➢ symptoms/clinical findings: • abdominal pain • N/V • fatty stools • wt loss ➢ lab tests/findings: • abnormal 72 h fecal fat test • malabsorption of many nutrients • hypoCa, hypoMg, hypoK • serum enzyme levels plasma glucose...
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