Effects of Polymeric Formula vs Elemental Formula in Neonatal Piglets With Short Bowel Syndrome

Hua, Zheng; Turner, Justine; Mager, Diana R.; Sigalet, David L.; Wizzard, Pamela; Nation, Patrick N.; Ball, Ron O; Pencharz, Paul B.; Wales, Paul W.

doi:10.1177/0148607113489151

Cited by 17 publications

(9 citation statements)

References 39 publications

(47 reference statements)

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“…Studies in piglets that compared elemental diets with bovine milk-based diets have also uncovered potential benefits of elemental diets. Piglets are the best nonprimate model for studying neonatal nutrition because the gastrointestinal anatomy, physiology, and nutrient requirements of pigs are the most similar to humans (86). In one such study, Connor et al (87) compared polymeric and elemental formulas for 3 surgically created short-bowel syndrome groups: 1) midintestinal resection with a jejunoileal anastomosis (equal amount of jejunum and ileum remaining) (n = 16); 2) distal intestinal resection, including the ileum, cecum, and 5 cm of the spiral colon, with a jejunocolic anastomosis (n = 17); and 3) sham surgery (n = 15).…”

Section: Sources Of Nutritionmentioning

confidence: 99%

Current Knowledge of Necrotizing Enterocolitis in Preterm Infants and the Impact of Different Types of Enteral Nutrition Products

Shulhan¹,

Dicken²,

Hartling³

et al. 2017

Advances in Nutrition

104

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Preterm infants are extremely vulnerable to a range of morbidities and mortality. Underdeveloped cardiac, respiratory, gastrointestinal, and immune systems in the preterm period increase the risk of necrotizing enterocolitis (NEC), a serious disease of the gut. NEC affects 5-12% of very-low birthweight infants, leads to surgery in 20-40% of cases, and is fatal in 25-50% of cases. There are multiple factors that may contribute to NEC, but the exact cause is not yet fully understood. Severe cases can result in intestinal resection or death, and the health care costs average >$300,000/infant when surgical management is required. Different types of nutrition may affect the onset or progression of NEC. Several studies have indicated that bovine milk-based infant formulas lead to a higher incidence of NEC in preterm infants than does human milk (HM). However, it is not clear why HM is linked to a lower incidence of NEC or why some infants fed an exclusively HM diet still develop NEC. An area that has not been thoroughly explored is the use of semielemental or elemental formulas. These specialty formulas are easy to digest and absorb in the gut and may be an effective nutritional intervention for reducing the risk of NEC. This review summarizes what is known about the factors that contribute to the onset and progression of NEC, discusses its health care cost implications, and explores the impact that different formulas and HM have on this disease. Adv Nutr 2017;8:80-91.

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Section: Sources Of Nutritionmentioning

confidence: 99%

Current Knowledge of Necrotizing Enterocolitis in Preterm Infants and the Impact of Different Types of Enteral Nutrition Products

Shulhan¹,

Dicken²,

Hartling³

et al. 2017

Advances in Nutrition

104

View full text Add to dashboard Cite

show abstract

“…Compared with intact protein, an elemental diet obviously requires less processing of protein digestion before absorption. And also report of Hua et al showed that SBS piglets without ileum had less ability to tolerate polymeric formula [11]. Interestingly, the patient was given a polymeric formula with fiber first.…”

Section: Discussionmentioning

confidence: 98%

Nutritional Support Process for a Patient with Short Bowel Syndrome in Conjunction with Panperitonitis: A Case Report

Kim

Lee

et al. 2013

Clin Nutr Res

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Short Bowel Syndrome (SBS) is a condition that causes malabsorption and nutrient deficiency because a large section of the small intestine is missing or has been surgically removed. SBS may develop congenitally or from gastroenterectomy, which often change the motility, digestive, and/or absorptive functions of the small bowel. The surgical procedure for SBS and the condition itself have high mortality rates and often lead to a range of complications associated with long-term parenteral nutrition (PN). Therefore, careful management and appropriate nutrition intervention are needed to prevent complications and to help maintain the physiologic integrity of the remaining intestinal functions. Initial postoperative care should provide adequate hydration, electrolyte support and total parenteral nutrition (TPN) to prevent fatal dehydration. Simultaneously, enteral nutrition should be gradually introduced, with the final goal of using only enteral nutrition support and/or oral intake and eliminating TPN from the diet. A patient should be considered for discharge when macro and micronutrients can be adequately supplied through enteral nutrition support or oral diet. Currently, there is more research on pediatric patients with SBS than on adult patient population. A 35-year-old man with no notable medical history was hospitalized and underwent a surgery for acute appendicitis at a local hospital. He was re-operated on the 8th day after the initial surgery due to complications and was under observation when he suddenly complained of severe abdominal pain and high fever. He was immediately transferred to a tertiary hospital where the medical team discovered free air in the abdomen. He was subsequently diagnosed with panperitonitis and underwent an emergency reoperation to explore the abdomen. Although the patient was expected to be at a high risk of malnutrition due to short bowel syndrome resulting from multiple surgeries, through intensive care under close cooperation between the medical and nutrition support team, his nutritional status improved significantly through continuous central and peripheral parenteral nutrition, enteral nutrition, and oral intake. The purpose of this paper is to report the process of the patient's recovery.

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“…In the current study, the patient was recommended a polymeric high caloric formula through ileostomy which resulted in his readmission with relapse of acute renal failure and decline in nutritional status. Inclusion of polymeric formula instead of elemental formula in postoperative diet for jejunocolic anastomosis has been linked to negative clinical outcomes including diarrhea and longer duration of parental support [12].…”

Section: Discussionmentioning

confidence: 99%

Postoperative nutritional support of the patient with gut gangrene—a case report

Imran¹,

Tanweer

2019

J Health Popul Nutr

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Background Bowel necrosis is a commonly observed condition in elderly patients with longstanding diabetes. In such condition, intestinal resection is usually performed for the removal of the gangrenous part. Post-surgical dietary management after bowel resection poses several challenges for the health care team. Case presentation The case presented in this study is that of an elderly diabetic male who developed acute renal failure as a result of neglect in post-surgical feeding after intestinal resection. After the intervention by a trained dietitian, a transitional diet was planned and successfully executed, resulting in reversal of acute renal failure, dehydration, and post-surgical stress. Several complications including hepatic dysfunction and mouth ulcers were resolved through well-planned transitional diet. The patient was finally discharged in a stable health condition and was regularly followed up for any nutritional or medical issues. Conclusion Neglects in nutritional care of patients can have severe implications including development of medical complications, resulting in increased length of hospital stay, augmenting the disease stress of the patient and family, and finally the preventable drainage of several human and monetary resources. Therefore, recognition of nutritional intervention as an important part of in-hospital health care may have social as well as economic impacts.

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Effects of Polymeric Formula vs Elemental Formula in Neonatal Piglets With Short Bowel Syndrome

Abstract: An overall benefit of the polymeric formula over the elemental formula on gut adaptation was not observed. Furthermore, SBS piglets without ileum had less ability to tolerate polymeric formula, contributing to more days of PN support.

Cited by 17 publications

References 39 publications

Current Knowledge of Necrotizing Enterocolitis in Preterm Infants and the Impact of Different Types of Enteral Nutrition Products

Current Knowledge of Necrotizing Enterocolitis in Preterm Infants and the Impact of Different Types of Enteral Nutrition Products

Nutritional Support Process for a Patient with Short Bowel Syndrome in Conjunction with Panperitonitis: A Case Report

Postoperative nutritional support of the patient with gut gangrene—a case report

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