A 40-year-old man with severe acute pancreatitis requires nutritional support. He has a functioning gastrointestinal tract but cannot tolerate oral intake due to ileus. According to ESPEN guidelines, what is the preferred initial route and type of nutritional support?
- A Total parenteral nutrition via central line with standard amino acid solution
- B Enteral nutrition via nasojejunal tube with standard polymeric formula
- C Enteral nutrition via nasogastric tube with semi-elemental formula ✓
- D Parenteral nutrition supplemented with glutamine and omega-3 fatty acids
Correct answer: C. Enteral nutrition via nasogastric tube with semi-elemental formula
Explanation
ESPEN 2023 guidelines for acute pancreatitis recommend enteral nutrition over parenteral nutrition when the GI tract is accessible. Nasogastric feeding is acceptable and equivalent to nasojejunal feeding. Semi-elemental or standard polymeric formulas can be used. Parenteral nutrition is reserved for patients who cannot tolerate enteral feeding. Glutamine supplementation in PN is recommended for critically ill patients.
Reference: ESPEN guideline on clinical nutrition in acute and chronic pancreatitis, 2023 ed.
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Written and medically reviewed by the StethoPrep medical team.