From the 1Division of Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH; and 2Division of Gastroenterology, Hepatology, and Nutrition, Rady Children's Hospital, San Diego, CA
Checking for direct PDF access through Ovid
ObjectiveTo determine whether early patient-directed oral nutrition in children with mild acute pancreatitis decreases the length of hospitalization without increasing complications.Study designHospitalized patients aged 2–21 years of age who met the criteria for acute pancreatitis based on the Revised Atlanta Classification were enrolled prospectively and allowed to eat by mouth at their discretion (patient-directed nutrition [PDN]). These patients were compared with a retrospective cohort of children who were allowed to eat based on traditional practices (treatment team-directed nutrition [TTDN]). Outcomes included length of hospitalization, time nil per os (NPO), and complications within 30 days of discharge.ResultsThe study included 30 patients in the PDN group and 92 patients in the TTDN group. Patients in the PDN group had a median length of stay of 48.5 hours (IQR 37–70 hours) compared with 93 hours (IQR 52–145 hours) in the TTDN group (P < .0001). Patients were NPO for a median of 14 hours (IQR 7–19.5 hours) in the PDN group compared with 34 hours (IQR 19.3–55 hours) in the TTDN group (P < .0001). No patients in the PDN group developed complications within 30 days of discharge.ConclusionEarly patient-directed oral nutrition in mild acute pancreatitis was well tolerated and resulted in decreased length of NPO status and hospitalization with no obvious complications.Clinical Trial RegistrationClinicalTrials.gov: NCT01423786.