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Janet A Brunton - One of the best experts on this subject based on the ideXlab platform.
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Enteral Feeding induces early intestinal adaptation in a parEnterally fed neonatal piglet model of short bowel syndrome
Journal of Parenteral and Enteral Nutrition, 2012Co-Authors: Elaine M Dodge, Robert F Bertolo, Janet A BruntonAbstract:BACKGROUND: Successful small intestinal (SI) adaptation following surgical resection is essential for optimizing newborn growth and development, but the potential for adaptation is unknown. The authors developed an SI resection model in neonatal piglets supported by intravenous and Enteral nutrition. METHODS: Piglets (n = 33, 12-13 days old) were randomized to 80% SI resection with parEnteral nutrition Feeding (R-PN), 80% SI resection with PN + Enteral Feeding (R-EN), or sham SI transection with PN + Enteral Feeding (sham-EN). In resected pigs, the distal 100 cm of ileum (residual SI) and 30 cm of proximal SI were left intact. All pigs received parEnteral nutrition postsurgery. Enteral nutrition piglets received continuous gastric infusion of elemental diet from day 3 (40:60 parEnteral nutrition:Enteral nutrition). Piglets were killed 4, 6, or 10 days postsurgery. RESULTS: By 10 days, R-EN piglets had longer residual SI than R-PN and sham-EN pigs (P < .05). At days 6 and 10, R-EN piglets had greater weight per length of intact SI (P < .05) and isolated mucosa (P < .05) compared to other groups. Greater gut weight in R-EN piglets was facilitated by a greater cellular proliferation index (P < .01) by 4 days compared to other groups and greater overall ornithine decarboxylase activity vs R-PN piglets (P < .05). CONCLUSIONS: This new model demonstrated profound SI adaptation, initiated early postsurgery by polyamine synthesis and crypt cell proliferation and only in response to Enteral Feeding. These changes translated to greater gut mass and length within days, likely improving functional capacity long term.
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Enteral Feeding induces early intestinal adaptation in a parEnterally fed neonatal piglet model of short bowel syndrome
Journal of Parenteral and Enteral Nutrition, 2012Co-Authors: Elaine M Dodge, Robert F Bertolo, Janet A BruntonAbstract:Background: Successful small intestinal (SI) adaptation following surgical resection is essential for optimizing newborn growth and development, but the potential for adaptation is unknown. The authors developed an SI resection model in neonatal piglets supported by intravenous and Enteral nutrition. Methods: Piglets (n = 33, 12–13 days old) were randomized to 80% SI resection with parEnteral nutrition Feeding (R-PN), 80% SI resection with PN + Enteral Feeding (R-EN), or sham SI transection with PN + Enteral Feeding (sham-EN). In resected pigs, the distal 100 cm of ileum (residual SI) and 30 cm of proximal SI were left intact. All pigs received parEnteral nutrition postsurgery. Enteral nutrition piglets received continuous gastric infusion of elemental diet from day 3 (40:60 parEnteral nutrition:Enteral nutrition). Piglets were killed 4, 6, or 10 days postsurgery. Results: By 10 days, R-EN piglets had longer residual SI than R-PN and sham-EN pigs (P < .05). At days 6 and 10, R-EN piglets had greater weigh...
Elaine M Dodge - One of the best experts on this subject based on the ideXlab platform.
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Enteral Feeding induces early intestinal adaptation in a parEnterally fed neonatal piglet model of short bowel syndrome
Journal of Parenteral and Enteral Nutrition, 2012Co-Authors: Elaine M Dodge, Robert F Bertolo, Janet A BruntonAbstract:BACKGROUND: Successful small intestinal (SI) adaptation following surgical resection is essential for optimizing newborn growth and development, but the potential for adaptation is unknown. The authors developed an SI resection model in neonatal piglets supported by intravenous and Enteral nutrition. METHODS: Piglets (n = 33, 12-13 days old) were randomized to 80% SI resection with parEnteral nutrition Feeding (R-PN), 80% SI resection with PN + Enteral Feeding (R-EN), or sham SI transection with PN + Enteral Feeding (sham-EN). In resected pigs, the distal 100 cm of ileum (residual SI) and 30 cm of proximal SI were left intact. All pigs received parEnteral nutrition postsurgery. Enteral nutrition piglets received continuous gastric infusion of elemental diet from day 3 (40:60 parEnteral nutrition:Enteral nutrition). Piglets were killed 4, 6, or 10 days postsurgery. RESULTS: By 10 days, R-EN piglets had longer residual SI than R-PN and sham-EN pigs (P < .05). At days 6 and 10, R-EN piglets had greater weight per length of intact SI (P < .05) and isolated mucosa (P < .05) compared to other groups. Greater gut weight in R-EN piglets was facilitated by a greater cellular proliferation index (P < .01) by 4 days compared to other groups and greater overall ornithine decarboxylase activity vs R-PN piglets (P < .05). CONCLUSIONS: This new model demonstrated profound SI adaptation, initiated early postsurgery by polyamine synthesis and crypt cell proliferation and only in response to Enteral Feeding. These changes translated to greater gut mass and length within days, likely improving functional capacity long term.
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Enteral Feeding induces early intestinal adaptation in a parEnterally fed neonatal piglet model of short bowel syndrome
Journal of Parenteral and Enteral Nutrition, 2012Co-Authors: Elaine M Dodge, Robert F Bertolo, Janet A BruntonAbstract:Background: Successful small intestinal (SI) adaptation following surgical resection is essential for optimizing newborn growth and development, but the potential for adaptation is unknown. The authors developed an SI resection model in neonatal piglets supported by intravenous and Enteral nutrition. Methods: Piglets (n = 33, 12–13 days old) were randomized to 80% SI resection with parEnteral nutrition Feeding (R-PN), 80% SI resection with PN + Enteral Feeding (R-EN), or sham SI transection with PN + Enteral Feeding (sham-EN). In resected pigs, the distal 100 cm of ileum (residual SI) and 30 cm of proximal SI were left intact. All pigs received parEnteral nutrition postsurgery. Enteral nutrition piglets received continuous gastric infusion of elemental diet from day 3 (40:60 parEnteral nutrition:Enteral nutrition). Piglets were killed 4, 6, or 10 days postsurgery. Results: By 10 days, R-EN piglets had longer residual SI than R-PN and sham-EN pigs (P < .05). At days 6 and 10, R-EN piglets had greater weigh...
Edward Hurrell - One of the best experts on this subject based on the ideXlab platform.
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biofilm formation on Enteral Feeding tubes by cronobacter sakazakii salmonella serovars and other enterobacteriaceae
International Journal of Food Microbiology, 2009Co-Authors: Edward Hurrell, Eva Kucerova, Michael F Loughlin, Juncal Caubillabarron, Stephen J. ForsytheAbstract:Abstract WHO (2007) recommended that to reduce microbial risks, powdered infant formula should be reconstituted with water at temperatures > 70 °C, and that such feeds should be used within 2 h of preparation. However, this recommendation does not consider the use of Enteral Feeding tubes which can be in place for more than 48 h and can be loci for bacterial attachment. This study determined the extent to which 29 strains of Cronobacter sakazakii, Salmonella serovars, other Enterobacteriaceae and Acinetobacter spp. can adhere and grow on Enteral Feeding tubes composed of polyvinyl chloride and polyurethane. The study also included silver-impregnated tubing which was expected to have antibacterial activity. Bacterial biofilm formation by members of the Enterobacteriaceae was ca. 105–106 cfu/cm after 24 h. Negligible biofilm was detected for Acinetobacter gensp. 13; ca. 10 cfu/cm, whereas Cr. sakazakii strain ATCC 12868 had the highest biofilm cell density of 107 cfu/cm. Biofilm formation did not correlate with capsule production, and was not inhibited on silver-impregnated tubing. Bacteria grew in the tube lumen to cell densities of 107 cfu/ml within 8 h, and 109 cfu/ml within 24 h. It is plausible that in vivo the biofilm will both inoculate subsequent routine feeds and as the biofilm ages, clumps of cells will be shed which may survive passage through the neonate's stomach. Therefore biofilm formation on Enteral Feeding tubes constitutes a risk factor for susceptible neonates.
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biofilm formation on Enteral Feeding tubes by cronobacter sakazakii salmonella serovars and other enterobacteriaceae
International Journal of Food Microbiology, 2009Co-Authors: Edward Hurrell, Eva Kucerova, Michael F Loughlin, Juncal Caubillabarron, Stephen J. ForsytheAbstract:WHO (2007) recommended that to reduce microbial risks, powdered infant formula should be reconstituted with water at temperatures >70 degrees C, and that such feeds should be used within 2h of preparation. However, this recommendation does not consider the use of Enteral Feeding tubes which can be in place for more than 48h and can be loci for bacterial attachment. This study determined the extent to which 29 strains of Cronobacter sakazakii, Salmonella serovars, other Enterobacteriaceae and Acinetobacter spp. can adhere and grow on Enteral Feeding tubes composed of polyvinyl chloride and polyurethane. The study also included silver-impregnated tubing which was expected to have antibacterial activity. Bacterial biofilm formation by members of the Enterobacteriaceae was ca. 10(5)-10(6) cfu/cm after 24h. Negligible biofilm was detected for Acinetobacter gensp. 13; ca. 10 cfu/cm, whereas Cr. sakazakii strain ATCC 12868 had the highest biofilm cell density of 10(7) cfu/cm. Biofilm formation did not correlate with capsule production, and was not inhibited on silver-impregnated tubing. Bacteria grew in the tube lumen to cell densities of 10(7)cfu/ml within 8h, and 10(9)cfu/ml within 24h. It is plausible that in vivo the biofilm will both inoculate subsequent routine feeds and as the biofilm ages, clumps of cells will be shed which may survive passage through the neonate's stomach. Therefore biofilm formation on Enteral Feeding tubes constitutes a risk factor for susceptible neonates.
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neonatal Enteral Feeding tubes as loci for colonisation by members of the enterobacteriaceae
BMC Infectious Diseases, 2009Co-Authors: Edward Hurrell, Eva Kucerova, Michael F Loughlin, Juncal Caubillabarron, Anthony C Hilton, Richard A Armstrong, C U M Smith, Judith Grant, Shiu Shoo, S J ForsytheAbstract:The objective of this study was to determine whether neonatal nasogastric Enteral Feeding tubes are colonised by the opportunistic pathogen Cronobacter spp. (Enterobacter sakazakii) and other Enterobacteriaceae, and whether their presence was influenced by the Feeding regime. One hundred and twenty-nine tubes were collected from two neonatal intensive care units (NICU). A questionnaire on Feeding regime was completed with each sample. Enterobacteriaceae present in the tubes were identified using conventional and molecular methods, and their antibiograms determined. The neonates were fed breast milk (16%), fortified breast milk (28%), ready to feed formula (20%), reconstituted powdered infant formula (PIF, 6%), or a mixture of these (21%). Eight percent of tubes were received from neonates who were 'nil by mouth'. Organisms were isolated from 76% of Enteral Feeding tubes as a biofilm (up to 107 cfu/tube from neonates fed fortified breast milk and reconstituted PIF) and in the residual lumen liquid (up to 107 Enterobacteriaceae cfu/ml, average volume 250 μl). The most common isolates were Enterobacter cancerogenus (41%), Serratia marcescens (36%), E. hormaechei (33%), Escherichia coli (29%), Klebsiella pneumoniae (25%), Raoultella terrigena (10%), and S. liquefaciens (12%). Other organisms isolated included C. sakazakii (2%),Yersinia enterocolitica (1%),Citrobacter freundii (1%), E. vulneris (1%), Pseudomonas fluorescens (1%), and P. luteola (1%). The Enteral Feeding tubes were in place between 48 h (13%). All the S. marcescens isolates from the Enteral Feeding tubes were resistant to amoxicillin and co-amoxiclav. Of additional importance was that a quarter of E. hormaechei isolates were resistant to the 3rd generation cephalosporins ceftazidime and cefotaxime. During the period of the study, K. pneumoniae and S. marcescens caused infections in the two NICUs. This study shows that neonatal Enteral Feeding tubes, irrespective of Feeding regime, act as loci for the bacterial attachment and multiplication of numerous opportunistic pathogens within the Enterobacteriaceae family. Subsequently, these organisms will enter the stomach as a bolus with each feed. Therefore, Enteral Feeding tubes are an important risk factor to consider with respect to neonatal infections.
Marin H Kollef - One of the best experts on this subject based on the ideXlab platform.
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early versus late Enteral Feeding of mechanically ventilated patients results of a clinical trial
Journal of Parenteral and Enteral Nutrition, 2002Co-Authors: Emad H Ibrahim, Lisa Mehringer, Donna Prentice, Glenda Sherman, Robyn Schaiff, Victoria J Fraser, Marin H KollefAbstract:BACKGROUND: This study sought to compare 2 strategies for the administration of Enteral Feeding to mechanically ventilated medical patients. METHODS: The prospective, controlled, clinical trial was carried out in a medical intensive care unit (19 beds) in a university-affiliated, urban teaching hospital. Between May 1999 and December 2000, 150 patients were enrolled. Patients were scheduled to receive their estimated total daily Enteral nutritional requirements on either day 1 (early-Feeding group) or day 5 (late-Feeding group) of mechanical ventilation. Patients in the late-Feeding group were also scheduled to receive 20% of their estimated daily Enteral nutritional requirements during the first 4 days of mechanical ventilation. RESULTS: Seventy-five (50%) consecutive eligible patients were entered into the early-Feeding group and 75 (50%) patients were enrolled in the late-Feeding group. During the 5 five days of mechanical ventilation, the total intake of calories (2370 +/- 2000 kcal versus 629 +/- 575...
Robert F Bertolo - One of the best experts on this subject based on the ideXlab platform.
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Enteral Feeding induces early intestinal adaptation in a parEnterally fed neonatal piglet model of short bowel syndrome
Journal of Parenteral and Enteral Nutrition, 2012Co-Authors: Elaine M Dodge, Robert F Bertolo, Janet A BruntonAbstract:BACKGROUND: Successful small intestinal (SI) adaptation following surgical resection is essential for optimizing newborn growth and development, but the potential for adaptation is unknown. The authors developed an SI resection model in neonatal piglets supported by intravenous and Enteral nutrition. METHODS: Piglets (n = 33, 12-13 days old) were randomized to 80% SI resection with parEnteral nutrition Feeding (R-PN), 80% SI resection with PN + Enteral Feeding (R-EN), or sham SI transection with PN + Enteral Feeding (sham-EN). In resected pigs, the distal 100 cm of ileum (residual SI) and 30 cm of proximal SI were left intact. All pigs received parEnteral nutrition postsurgery. Enteral nutrition piglets received continuous gastric infusion of elemental diet from day 3 (40:60 parEnteral nutrition:Enteral nutrition). Piglets were killed 4, 6, or 10 days postsurgery. RESULTS: By 10 days, R-EN piglets had longer residual SI than R-PN and sham-EN pigs (P < .05). At days 6 and 10, R-EN piglets had greater weight per length of intact SI (P < .05) and isolated mucosa (P < .05) compared to other groups. Greater gut weight in R-EN piglets was facilitated by a greater cellular proliferation index (P < .01) by 4 days compared to other groups and greater overall ornithine decarboxylase activity vs R-PN piglets (P < .05). CONCLUSIONS: This new model demonstrated profound SI adaptation, initiated early postsurgery by polyamine synthesis and crypt cell proliferation and only in response to Enteral Feeding. These changes translated to greater gut mass and length within days, likely improving functional capacity long term.
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Enteral Feeding induces early intestinal adaptation in a parEnterally fed neonatal piglet model of short bowel syndrome
Journal of Parenteral and Enteral Nutrition, 2012Co-Authors: Elaine M Dodge, Robert F Bertolo, Janet A BruntonAbstract:Background: Successful small intestinal (SI) adaptation following surgical resection is essential for optimizing newborn growth and development, but the potential for adaptation is unknown. The authors developed an SI resection model in neonatal piglets supported by intravenous and Enteral nutrition. Methods: Piglets (n = 33, 12–13 days old) were randomized to 80% SI resection with parEnteral nutrition Feeding (R-PN), 80% SI resection with PN + Enteral Feeding (R-EN), or sham SI transection with PN + Enteral Feeding (sham-EN). In resected pigs, the distal 100 cm of ileum (residual SI) and 30 cm of proximal SI were left intact. All pigs received parEnteral nutrition postsurgery. Enteral nutrition piglets received continuous gastric infusion of elemental diet from day 3 (40:60 parEnteral nutrition:Enteral nutrition). Piglets were killed 4, 6, or 10 days postsurgery. Results: By 10 days, R-EN piglets had longer residual SI than R-PN and sham-EN pigs (P < .05). At days 6 and 10, R-EN piglets had greater weigh...