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When should we start oral intake in children with severe acute pancreatitis?
  1. Nilton Y Carreazo1,2,
  2. Karim Ugarte1,
  3. Carlos Bada1,2
  1. 1Critical Appraisal Skills Programme Perú. Servicio de Pediatría - Hospital de Emergencias Pediátricas
  2. 2Unidad de Post Grado. Facultad de Medicina Humana Universidad de San Martín de Porres, Lima, Perú

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This Notebook was previously published in Evidence-Based Medicine. It provides an example of how 3 clinicians used evidence-based decision making in a hospital setting. We welcome submissions of similar examples of using evidence in clinical decision making.

Last year, 2 children recovering from acute severe pancreatitis were transferred from the intensive care unit (ICU) to our care in the paediatric ward.

Patient 1 was a 9-year old girl diagnosed with acute severe pancreatitis (Imrie score  =  5, computed tomography [CT] abdomen staging  =  Balthazar E, which included pancreatic necrosis).12 She received antibiotics (ceftriaxone, metronidazole), analgesics (pethidine, fentanyl), anti-acid therapy (ranitidine), and nasojejunal feeding. She had been in hospital for 25 days (16 in ICU) and had received nasojejunal tube feeding for 20 days.

Patient 2 was a 9-year old boy, again with acute severe pancreatitis (Imrie score  =  4, CT abdomen staging  =  Balthazar E). In the Emergencias Pediátricas Hospital, he was admitted to the ICU, where he received antibiotic therapy (ciprofloxacin, metronidazole), analgesics (pethidine), anti-acid therapy (ranitidine), and nasojejunal feeding. He had been in hospital for 9 days (7 days in ICU) and had been feeding by nasojejunal tube for 4 days. He asked during the ward round, “When are …

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