Early nasogastric enteral nutrition for severe acute pancreatitis: A systematic review

Table 1 Details of included RCTs

Reference	Yr	Country	Number of intervention/control	Inclusion/exclusion criteria of participants		Drop-out/withdrawal
[15]	2005	Scotland	27 (NGEN)/23 (NJEN)	Inclusion: both a clinical and biochemical presentation of AP (abdominal pain and serum amylase at least 3 times the upper limit of the reference range), and objective evidence of disease of disease severity (Glasgow prognostic score ≥ 3, or APACHE II ≥ 6, or CRP > 150 mg/L).		One excluded in NJEN group for misdiagnosed and 2 in NJEN group received NGEN for failure of NJ tube placement.
				Exclusion: patients under 18 yr of age and pregnant females.
				Inclusion: severity was defined according to the Atlanta criteria (ie, presence of organ failure and APACHE score of ≥ 8 or CT severity score ≥ 7).
[16]	2006	India	16 (NGEN)/15 (NJEN)	Exclusion: if there was a delay of more than 4 wk between the onset of symptoms and presentation to the hospital, if they were already taking oral feeding at presentation, if there was acute exacerbation of chronic pancreatitis, or if they were in shock (ie, systolic blood pressure < 90 mmHg at the time of randomization).		One excluded in NJEN group for failure of NJ tube placement.
[17]	2006	Sweden	24 (NGEN)/26 (TPN)	Inclusion: abdominal pain, amylase ≥ 3 times upper limit of normal, onset of abdominal pain within 48 h, APACHE II score ≥ 8 and/or CRP ≥ 150 mg/L and/or peripancreatic liquid shown on CT.		One patient from each group was considered as protocol violators due to surgery performed after study inclusion on d 2 in 1 case, and a dislocated tube not accepted to be replaced in the other one
				Exclusion: AP due to surgery, inflammatory bowel disease, stoma, short bowel, chronic pancreatitis with exacerbation, and patients under 18 yr of age.

Abbreviations: RCT: Randomized controlled trial; NGEN, nasogastric enteral nutrition; NJEN, nasojejunal enteral nutrition; TPN, total parenteral nutrition; AP, acute pancreatitis; SAP, severe acute pancreatitis; APACHE, acute physiology and chronic health evaluation; CTSI, computer tomography severity index; CRP, C-reactive protein.

Table 2 Quality of included RCTs¹

Study	Randomization method	Allocation concealment	Blind method	ITT method	Jadad score
Eatock et al[15], 2005	Computer-generated random numbers	Adequate	Not used	Yes	3
Kumar et al[16], 2006	Computer-generated random numbers	Unclear	Not used	Unclear	3
Eckerwall et al[17], 2006	Not specified	Adequate	Not used	Yes	2

¹According to the Cochrane Handbook for Systematic Review 4.2.6[13].