High versus gradually increasing energy nutrition in the early phase of acute pancreatitis (GOULASH): a multicentre double-blind randomised clinical trial - PubMed
3 days ago
- #nutritional support
- #acute pancreatitis
- #clinical trial
- The GOULASH trial compared high-energy (HE) versus gradually increasing low-energy (LE) nutritional strategies in acute pancreatitis (AP).
- Primary outcome (mortality/severe AP) showed no significant difference between HE and LE groups (9.0% vs 5.7%, p=0.19/0.42).
- Secondary outcomes initially favored LE for organ failure (16.7% vs 9.1%, p=0.007) and pain relapse (27.1% vs 19.0%, p=0.03), but significance disappeared after correction for multiple testing.
- Trial was stopped early (636 patients) due to futility and ethical considerations, as HE showed no superiority.
- Conclusion: High-energy early nutrition in AP does not reduce mortality/severity but may increase organ failure and pain relapse risks.