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Nasogastric or nasojejunal feeding in pediatric acute pancreatitis: a randomized controlled trial

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Abstract

Background

The aim of this study was to compare nasogastric (NG) feeding with nasojejunal (NJ) feeding when treating pediatric patients with acute pancreatitis (AP).

Methods

We performed a single-center, prospective, randomized, active-controlled trial involving 77 pediatric patients with AP from April 2014 to December 2017. The patients were randomized into two groups: the NG tube feeding group (34 patients) and the NJ tube feeding group (33 patients). The primary outcome measures included the enteral nutrition intolerance, the length of tube feeding time, the recurrent pain of pancreatitis and complications.

Results

A total of 62 patients with AP (31 patients for each group) came into the final analysis. No differences were found in baseline characteristics, pediatric AP score and computed tomography severity score between the two groups. Three (9.7%) patients in the NG group and one (3.2%) patient in the NJ group developed intolerance (relative risk = 3.00, 95% confidence interval 0.33–27.29, P = 0.612). The tube feeding time and length of hospital stay of the NG group were significantly shorter than those of the NJ group (P = 0.016 and 0.027, respectively). No patient died in the trial. No significant differences were found in recurrent pain, complications, nutrition delivery efficacy, and side effects between the two groups.

Conclusions

NG tube feeding appears to be effective and safe for acute pediatric pancreatitis compared with NJ tube feeding. In addition, high qualified, large sample sized, randomized controlled trials in pediatric population are needed.

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Acknowledgements

We thank the statisticians from the Statistics Department of the Children's Hospital Affiliated to Zhejiang University School of Medicine, for their help in data analysis.

Funding

This work was supported by Scientific Research Fund of Zhejiang Provincial Education Department (Y201738367). The funder/sponsor did not participate in the work.

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Authors and Affiliations

  1. Department of Gastroenterology, The Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310052 , China

    Hong Zhao, Yan Han, Ke-Rong Peng, You-You Luo, Jin-Dan Yu, You-Hong Fang, Jie Chen & Jin-Gan Lou

  2. National Clinical Research Center for Child Health, The Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China

    Jie Chen & Jin-Gan Lou

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  1. Hong Zhao
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  2. Yan Han
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  7. Jie Chen
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Contributions

ZH and HY contributed equally as co-first authors. ZH and HY conceptualized and designed the study, collected data, analyzed and interpreted the data, drafted the initial manuscript, reviewed and revised the manuscript. PKR, LYY, YJD, and FYH analyzed and interpreted the data, drafted the initial manuscript. CJ and LJG conceptualized and designed the study, coordinated and supervised data collection, and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Jin-Gan Lou.

Ethics declarations

Ethical approval

The study was approved by Ethics Committee of the Children’s Hospital, Zhejiang University School of Medicine. Informed consents to participate in the study have been obtained from participants and their legal guardians. Chinese Clinical Trial Registry, ChiCTR-TRC-14004511 (http://www.chictr.org.cn/showproj.aspx?proj=5061).

Conflict of interest

No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article. The authors have no conflict of interest to declare.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Zhao, H., Han, Y., Peng, KR. et al. Nasogastric or nasojejunal feeding in pediatric acute pancreatitis: a randomized controlled trial. World J Pediatr 17, 536–543 (2021). https://doi.org/10.1007/s12519-021-00441-0

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  • DOI: https://doi.org/10.1007/s12519-021-00441-0

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