Minimal Enteral Nutrition to Improve Adaptation After Intestinal Resection in Piglets and Infants

Lise Aunsholt; Niels Qvist; Per T. Sangild; Andreas Vegge; Barbara Stoll; Douglas G. Burrin; Palle Bekker Jeppesen; Thomas Eriksen; Steffen Husby; Thomas Thymann

doi:10.1177/0148607117690527

Minimal Enteral Nutrition to Improve Adaptation After Intestinal Resection in Piglets and Infants

Lise Aunsholt^*, Niels Qvist, Per T. Sangild, Andreas Vegge, Barbara Stoll, Douglas G. Burrin, Palle Bekker Jeppesen, Thomas Eriksen, Steffen Husby, Thomas Thymann

^*Corresponding author for this work

Department of Clinical Medicine

4 Citations (Scopus)

Abstract

Background: Minimal enteral nutrition (MEN) may induce a diet-dependent stimulation of gut adaptation following intestinal resection. Bovine colostrum is rich in growth factors, and we hypothesized that MEN with colostrum would stimulate intestinal adaptation, compared with formula, and would be well tolerated in patients with short bowel syndrome. Methods: In experiment 1, 3-day-old piglets with 50% distal small intestinal resection were fed parenteral nutrition (PN, n = 10) or PN plus MEN given as either colostrum (PN-COL, n = 5) or formula (PN-FORM, n = 9) for 7 days. Intestinal nutrient absorption and histomorphometry were performed. In experiment 2, tolerance and feasibility of colostrum supplementation were tested in a pilot study on 5 infants who had undergone intestinal resection, and they were compared with 5 resected infants who served as controls. Results: In experiment 1, relative wet-weight absorption and intestinal villus height were higher in PN-COL vs PN (53% vs 23% and 362 ± 13 vs 329 ± 7 µm, P <.05). Crypt depth and tissue protein synthesis were higher in PN-COL (233 ± 7 µm, 22%/d) and PN-FORM (262 ± 13 µm, 22%/d) vs PN (190 ± 4 µm, 9%/d, both P <.05). In experiment 2, enteral colostrum supplementation was well tolerated, and no infants developed clinical signs of cow’s milk allergy. Conclusion: Minimal enteral nutrition feeding with bovine colostrum and formula induced similar intestinal adaptation after resection in piglets. Colostrum was well tolerated by newly resected infants, but the clinical indication for colostrum supplementation to infants subjected to intestinal resection remains to be determined.

Original language	English
Journal	Journal of Parenteral and Enteral Nutrition
Volume	42
Issue number	2
Pages (from-to)	446-454
Number of pages	9
ISSN	0148-6071
DOIs	https://doi.org/10.1177/0148607117690527
Publication status	Published - Feb 2018

Keywords

enteral nutrition
gastroenterology
growth factors
life cycle
neonates
nutrition assessment
parenteral nutrition
surgery

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10.1177/0148607117690527

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title = "Minimal Enteral Nutrition to Improve Adaptation After Intestinal Resection in Piglets and Infants",

abstract = "Background: Minimal enteral nutrition (MEN) may induce a diet-dependent stimulation of gut adaptation following intestinal resection. Bovine colostrum is rich in growth factors, and we hypothesized that MEN with colostrum would stimulate intestinal adaptation, compared with formula, and would be well tolerated in patients with short bowel syndrome. Methods: In experiment 1, 3-day-old piglets with 50% distal small intestinal resection were fed parenteral nutrition (PN, n = 10) or PN plus MEN given as either colostrum (PN-COL, n = 5) or formula (PN-FORM, n = 9) for 7 days. Intestinal nutrient absorption and histomorphometry were performed. In experiment 2, tolerance and feasibility of colostrum supplementation were tested in a pilot study on 5 infants who had undergone intestinal resection, and they were compared with 5 resected infants who served as controls. Results: In experiment 1, relative wet-weight absorption and intestinal villus height were higher in PN-COL vs PN (53% vs 23% and 362 ± 13 vs 329 ± 7 µm, P <.05). Crypt depth and tissue protein synthesis were higher in PN-COL (233 ± 7 µm, 22%/d) and PN-FORM (262 ± 13 µm, 22%/d) vs PN (190 ± 4 µm, 9%/d, both P <.05). In experiment 2, enteral colostrum supplementation was well tolerated, and no infants developed clinical signs of cow{\textquoteright}s milk allergy. Conclusion: Minimal enteral nutrition feeding with bovine colostrum and formula induced similar intestinal adaptation after resection in piglets. Colostrum was well tolerated by newly resected infants, but the clinical indication for colostrum supplementation to infants subjected to intestinal resection remains to be determined.",

keywords = "enteral nutrition, gastroenterology, growth factors, life cycle, neonates, nutrition assessment, parenteral nutrition, surgery",

author = "Lise Aunsholt and Niels Qvist and Sangild, {Per T.} and Andreas Vegge and Barbara Stoll and Burrin, {Douglas G.} and Jeppesen, {Palle Bekker} and Thomas Eriksen and Steffen Husby and Thomas Thymann",

year = "2018",

month = feb,

doi = "10.1177/0148607117690527",

language = "English",

volume = "42",

pages = "446--454",

journal = "Journal of Parenteral and Enteral Nutrition",

issn = "0148-6071",

publisher = "SAGE Publications",

number = "2",

}

TY - JOUR

T1 - Minimal Enteral Nutrition to Improve Adaptation After Intestinal Resection in Piglets and Infants

AU - Aunsholt, Lise

AU - Qvist, Niels

AU - Sangild, Per T.

AU - Vegge, Andreas

AU - Stoll, Barbara

AU - Burrin, Douglas G.

AU - Jeppesen, Palle Bekker

AU - Eriksen, Thomas

AU - Husby, Steffen

AU - Thymann, Thomas

PY - 2018/2

Y1 - 2018/2

N2 - Background: Minimal enteral nutrition (MEN) may induce a diet-dependent stimulation of gut adaptation following intestinal resection. Bovine colostrum is rich in growth factors, and we hypothesized that MEN with colostrum would stimulate intestinal adaptation, compared with formula, and would be well tolerated in patients with short bowel syndrome. Methods: In experiment 1, 3-day-old piglets with 50% distal small intestinal resection were fed parenteral nutrition (PN, n = 10) or PN plus MEN given as either colostrum (PN-COL, n = 5) or formula (PN-FORM, n = 9) for 7 days. Intestinal nutrient absorption and histomorphometry were performed. In experiment 2, tolerance and feasibility of colostrum supplementation were tested in a pilot study on 5 infants who had undergone intestinal resection, and they were compared with 5 resected infants who served as controls. Results: In experiment 1, relative wet-weight absorption and intestinal villus height were higher in PN-COL vs PN (53% vs 23% and 362 ± 13 vs 329 ± 7 µm, P <.05). Crypt depth and tissue protein synthesis were higher in PN-COL (233 ± 7 µm, 22%/d) and PN-FORM (262 ± 13 µm, 22%/d) vs PN (190 ± 4 µm, 9%/d, both P <.05). In experiment 2, enteral colostrum supplementation was well tolerated, and no infants developed clinical signs of cow’s milk allergy. Conclusion: Minimal enteral nutrition feeding with bovine colostrum and formula induced similar intestinal adaptation after resection in piglets. Colostrum was well tolerated by newly resected infants, but the clinical indication for colostrum supplementation to infants subjected to intestinal resection remains to be determined.

AB - Background: Minimal enteral nutrition (MEN) may induce a diet-dependent stimulation of gut adaptation following intestinal resection. Bovine colostrum is rich in growth factors, and we hypothesized that MEN with colostrum would stimulate intestinal adaptation, compared with formula, and would be well tolerated in patients with short bowel syndrome. Methods: In experiment 1, 3-day-old piglets with 50% distal small intestinal resection were fed parenteral nutrition (PN, n = 10) or PN plus MEN given as either colostrum (PN-COL, n = 5) or formula (PN-FORM, n = 9) for 7 days. Intestinal nutrient absorption and histomorphometry were performed. In experiment 2, tolerance and feasibility of colostrum supplementation were tested in a pilot study on 5 infants who had undergone intestinal resection, and they were compared with 5 resected infants who served as controls. Results: In experiment 1, relative wet-weight absorption and intestinal villus height were higher in PN-COL vs PN (53% vs 23% and 362 ± 13 vs 329 ± 7 µm, P <.05). Crypt depth and tissue protein synthesis were higher in PN-COL (233 ± 7 µm, 22%/d) and PN-FORM (262 ± 13 µm, 22%/d) vs PN (190 ± 4 µm, 9%/d, both P <.05). In experiment 2, enteral colostrum supplementation was well tolerated, and no infants developed clinical signs of cow’s milk allergy. Conclusion: Minimal enteral nutrition feeding with bovine colostrum and formula induced similar intestinal adaptation after resection in piglets. Colostrum was well tolerated by newly resected infants, but the clinical indication for colostrum supplementation to infants subjected to intestinal resection remains to be determined.

KW - enteral nutrition

KW - gastroenterology

KW - growth factors

KW - life cycle

KW - neonates

KW - nutrition assessment

KW - parenteral nutrition

KW - surgery

U2 - 10.1177/0148607117690527

DO - 10.1177/0148607117690527

M3 - Journal article

C2 - 28786308

AN - SCOPUS:85042110944

SN - 0148-6071

VL - 42

SP - 446

EP - 454

JO - Journal of Parenteral and Enteral Nutrition

JF - Journal of Parenteral and Enteral Nutrition

IS - 2

ER -

Minimal Enteral Nutrition to Improve Adaptation After Intestinal Resection in Piglets and Infants

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