EPS05.1 Nutritional formula pre-hydrolyzed by novel point of care lipase device (EFIC™) leads to increased fat absorption in young pigs with exocrine pancreatic insufficiency (EPI)

Abstract

Background Patients with CF and EPI have difficulty managing weight requiring liquid supplements and tube feeds. Administration of PERTs with enteral feeding is challenging, as enzyme availability is mismatched with formula, negatively affecting fat digestion, absorption and leading to fatty acid deficiencies. EFIC contains an immobilized lipase within a cartridge that is a part of enteral feeding circuit. Formula passes through the EFIC pre-hydrolyzing triglycerides including polyunsaturated fatty acids (PUFA) such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) into absorbable fatty acids. This study measured fat absorption and changes in plasma profiles of DHA and EPA after feeding EPI pigs, with formula +/– EFIC. Methods Fasted EPI pigs were tube fed for 5 h (2 mL/min) with 500 mL Peptamen AF (Nestle, 32 g fat, 1.8 g DHA/EPA), either as EFIC pre-hydrolyzed (EPI+EFIC n = 6) or non-hydrolyzed (EPI n = 5) formula. 3 healthy age matched pigs served as controls. Ten plasma samples were collected over 24 h. Lipids were measured by lipaemic index (LI, turbidometry) and fatty acids by GC-MS and UPLC-MS. Results Fat absorption improved with EFIC compared to the non-hydrolyzed group with 5 h Cmax for LI and AUC 0–10 11.5±1.99 vs. 9.1±1.63 (p Conclusions Use of EFIC leads to an increase in total fat absorption and specifically, plasma levels of physiologically relevant PUFAs, such as DHA and EPA. EFIC provides an effective approach to optimizing fat hydrolysis, PUFA absorption and caloric intake during enteral feeding.