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
PY - 2021
Y1 - 2021
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
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 -