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Gastric Residual to Predict Necrotizing Enterocolitis in Preterm Piglets As Models for Infants

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Kappel, Susanne Soendergaard ; Sangild, Per Torp ; Hilsted, Linda ; Hartmann, Bolette ; Thymann, Thomas ; Aunsholt, Lise. / Gastric Residual to Predict Necrotizing Enterocolitis in Preterm Piglets As Models for Infants. I: Journal of Parenteral and Enteral Nutrition. 2021 ; Bind 45, Nr. 1. s. 87-93.

Bibtex

@article{acf501be124547ddb72f5e22e1883df3,
title = "Gastric Residual to Predict Necrotizing Enterocolitis in Preterm Piglets As Models for Infants",
abstract = "BACKGROUND: Necrotizing enterocolitis (NEC) is a serious intestinal inflammatory disease in preterm infants. High volume of gastric residual (GR) after oral feedings is often used as a predictor of NEC, but evidence is limited. Using NEC-sensitive preterm piglets as models, we hypothesized that GR mass and related plasma biomarkers predict early onset of NEC.METHODS: In total, 258 newborn preterm piglets were fed bovine milk-based formulas for 5 days. At euthanasia, the stomach, small intestine, and colon were evaluated for NEC lesions. Mass, acidity, gastrin, and bile acid levels were determined for GR content, together with gastrin, glucagon-like peptide 2 (GLP-2), and gastric inhibitory polypeptide (GIP) levels in plasma.RESULTS: In total, 48% of piglets had NEC lesions in the small intestine and/or colon. These piglets had higher GR mass (+32%, P < 0.001) and lower gastric bile acid concentrations (-22%, P < 0.05) than piglets without NEC lesions. The positive and negative predictive values for these markers were 34%-61%. Gastric acidity, gastrin, GLP-2, and GIP levels were similar for piglets with and without NEC lesions.CONCLUSION: Elevated GR mass correlates positively with NEC lesions but may be a poor predictor of NEC, even when combined with other biomarkers. More knowledge about gastric emptying and gut transit in preterm neonates is required to understand how GR volume and composition relate to morbidities, such as NEC, in preterm neonates.",
keywords = "enteral feeding, feeding intolerance, preterm infant",
author = "Kappel, {Susanne Soendergaard} and Sangild, {Per Torp} and Linda Hilsted and Bolette Hartmann and Thomas Thymann and Lise Aunsholt",
note = "{\textcopyright} 2020 American Society for Parenteral and Enteral Nutrition.",
year = "2021",
month = jan,
doi = "10.1002/jpen.1814",
language = "English",
volume = "45",
pages = "87--93",
journal = "Journal of Parenteral and Enteral Nutrition",
issn = "0148-6071",
publisher = "Sage Science Press (US)",
number = "1",

}

RIS

TY - JOUR

T1 - Gastric Residual to Predict Necrotizing Enterocolitis in Preterm Piglets As Models for Infants

AU - Kappel, Susanne Soendergaard

AU - Sangild, Per Torp

AU - Hilsted, Linda

AU - Hartmann, Bolette

AU - Thymann, Thomas

AU - Aunsholt, Lise

N1 - © 2020 American Society for Parenteral and Enteral Nutrition.

PY - 2021/1

Y1 - 2021/1

N2 - BACKGROUND: Necrotizing enterocolitis (NEC) is a serious intestinal inflammatory disease in preterm infants. High volume of gastric residual (GR) after oral feedings is often used as a predictor of NEC, but evidence is limited. Using NEC-sensitive preterm piglets as models, we hypothesized that GR mass and related plasma biomarkers predict early onset of NEC.METHODS: In total, 258 newborn preterm piglets were fed bovine milk-based formulas for 5 days. At euthanasia, the stomach, small intestine, and colon were evaluated for NEC lesions. Mass, acidity, gastrin, and bile acid levels were determined for GR content, together with gastrin, glucagon-like peptide 2 (GLP-2), and gastric inhibitory polypeptide (GIP) levels in plasma.RESULTS: In total, 48% of piglets had NEC lesions in the small intestine and/or colon. These piglets had higher GR mass (+32%, P < 0.001) and lower gastric bile acid concentrations (-22%, P < 0.05) than piglets without NEC lesions. The positive and negative predictive values for these markers were 34%-61%. Gastric acidity, gastrin, GLP-2, and GIP levels were similar for piglets with and without NEC lesions.CONCLUSION: Elevated GR mass correlates positively with NEC lesions but may be a poor predictor of NEC, even when combined with other biomarkers. More knowledge about gastric emptying and gut transit in preterm neonates is required to understand how GR volume and composition relate to morbidities, such as NEC, in preterm neonates.

AB - BACKGROUND: Necrotizing enterocolitis (NEC) is a serious intestinal inflammatory disease in preterm infants. High volume of gastric residual (GR) after oral feedings is often used as a predictor of NEC, but evidence is limited. Using NEC-sensitive preterm piglets as models, we hypothesized that GR mass and related plasma biomarkers predict early onset of NEC.METHODS: In total, 258 newborn preterm piglets were fed bovine milk-based formulas for 5 days. At euthanasia, the stomach, small intestine, and colon were evaluated for NEC lesions. Mass, acidity, gastrin, and bile acid levels were determined for GR content, together with gastrin, glucagon-like peptide 2 (GLP-2), and gastric inhibitory polypeptide (GIP) levels in plasma.RESULTS: In total, 48% of piglets had NEC lesions in the small intestine and/or colon. These piglets had higher GR mass (+32%, P < 0.001) and lower gastric bile acid concentrations (-22%, P < 0.05) than piglets without NEC lesions. The positive and negative predictive values for these markers were 34%-61%. Gastric acidity, gastrin, GLP-2, and GIP levels were similar for piglets with and without NEC lesions.CONCLUSION: Elevated GR mass correlates positively with NEC lesions but may be a poor predictor of NEC, even when combined with other biomarkers. More knowledge about gastric emptying and gut transit in preterm neonates is required to understand how GR volume and composition relate to morbidities, such as NEC, in preterm neonates.

KW - enteral feeding

KW - feeding intolerance

KW - preterm infant

UR - http://www.scopus.com/inward/record.url?scp=85080094015&partnerID=8YFLogxK

U2 - 10.1002/jpen.1814

DO - 10.1002/jpen.1814

M3 - Journal article

C2 - 32100882

VL - 45

SP - 87

EP - 93

JO - Journal of Parenteral and Enteral Nutrition

JF - Journal of Parenteral and Enteral Nutrition

SN - 0148-6071

IS - 1

ER -

ID: 61812748