230 Hypophosphatemia: A Risk Factor for Insulin Requirement in Elbw Infants?

Abstract

Abstracts ventilation (r:0.3 p<0.01), treatment with fentanyl (r:0.23 p<0.05), remifentanyl (r:0.25 p<0.05), and absolute and proportional gastric residual volume (r:0.24 p<0.05 and r:0.3 p<0.01, respectively). A negative association with daily enteral feeding volume (r:-0.37 p<0.01) was observed. Treatment with epinephrine or norepinephrine was also associated with a delay in the first defecation (5.6 vs 2.8 days p<0.01). Conclusions Mean time to first defecation in critically ill children is 4 days. Constipation in critically ill children seems to be associated with severity of illness. Enteral nutrition could help bowel motility. Background and aims Parenteral support is indicated in short bowl syndrome (SBS) patients with intestinal failure to avoid metabolic imbalance, electrolyte and nutrient deficiencies, and to maintain adequate growth and function. Length, function and adaptation of residual bowel, promoted by e.g. luminal stimulation by nutrients determine the subsequent form of therapy. Colostrum contains putative stimulatory factors why, we hypothesise that supplementation could promote adaptation in children with SBS. Intestinal absorption of energy and wet weight was used to assess efficacy of colostrum and to define intestinal failure. Methods and materials Nine children with SBS were included in a double-blinded randomised cross-over trial. Twenty percent of their enteral nutrition was replaced with bovine colostrum and a milk-mixture for 4 weeks, separated by a 4 week wash-out period. Between baseline and end of study, children were clinical and biological assessed 4 times. Results Four HPN-patients had mean energy absorption of basal metabolic rate (BMR) of 81% and wet weight absorption of basal fluid need (BFN) of 6% at baseline compared to 5 non-HPN-patients with mean energy absorption of BMR of 196% and wet weight absorption of BFN at 76%, p=0.02, p=0.05. Colostrum did not improved energy or wet weight absorption compared to milk-mix, p=0.85, p=0.59. Urea increased during colostrum supplementation, p=0.04. Conclusion The degree of intestinal function and a distinction between intestinal insufficiency and failure can successfully be assessed by energy and wet weight balance studies. Bovine colostrum did not promote intestinal adaptation. A RANDOMIZED PLACEBO CONTROLLED TRIAL OF BOVINE COLOSTRUM FED TO CHILDREN WITH SHORT BOWEL SYNDROME EVALUATED BY METABOLIC BALANCE STUDIES

Early Mineral Metabolism in Very‐Low‐Birth‐Weight Infants

“…It enters into the composition of the nucleic acids, the adenosine triphosphate, and the cell membrane (3,4). In addition to its role in bone mineralization, phosphorus (P) plays a major role in energy metabolism, acid‐base status, and cellular growth, and P depletion could be associated with potential deleterious outcomes, such as nephrocalcinosis, insulin resistance (5), and nosocomial infection (6).…”