Effect Of Enteral Feeding Research Articles

Obesity in children with acute lymphoblastic leukemia in remission: the evaluation of causes, hidden nutritional deficiency and the experience of its correction by using artificial enteral nutrition

Background. Antineoplastic treatment can have late toxic manifestations that can often appear after end of treatment. Children after treatment for acute lymphoblastic leukemia (ALL) have a risk of developing both obesity and undernutrition, which may be concealed by increased fat mass.Objective: to explore the incidence of obesity and hidden undernutrition in children with ALL and to describe the effect of enteral feeding using in these children.Materials and methods. In a retrospective study the data of 62 children with obesity that was revealed by standard examination was analyzed. The criterion of obesity was increased value of fat mass received by bioimpedance analysis. For this evaluation Russian bioimpedance analysis standards were used. Additionally, the included data were following: presence of endocrine pathology, weight change during latter 6 months before admission, physical activity and alimentary characteristics (usual regimen and structure of daily feed).Results. Only 54.8 % of patients with an actual excess of fat body mass index detected obesity (Z‑score higher than +2.00) and another 29 % body mass index was within the normal range (Z‑score from –1.00 to +1.00). This was the result of a tissue imbalance: reduce fat‑free mass. Some patients were diagnosed with insulin resistance and hyperinsulinemia. 83.7 % have a completely passive lifestyle. 49.0 % almost do not eat fruits and berries, 79.6 % – vegetables and 91.8 % – fish and seafood. Frequent intake of sweet dishes – 22.4 %, sausage products – 49.0 %, bakery products – 42.9 %, dishes from fast food restaurants – 42.9 %. 55.1 % of patients had more than 5 meals a day, while 18.4 % – less than 3. In or‑ der to correct hidden nutritional deficiencies, 22 patients received artificial nutritional formulas. They had a significant increase in fat‑free mass and a decrease in fat, in comparison with those who did not receive enteral feeding.Conclusion. Treatment‑associated factors, physical activity and alimentary causes play an important role in formation of not only obesity, but also hidden nutritional insufficiency in children with ALL after treatment. Enteral feeding using artificial polymeric formulas showed its effectiveness. An integrated and multidisciplinary approach to solving the problem is appropriate of prevention and treatment of obesity.

Feasibility, tolerance and effectiveness of enteral feeding in critically ill patients in prone position: More can be less with inappropriate analysis

Feasibility, tolerance and effectiveness of enteral feeding in critically ill patients in prone position: More can be less with inappropriate analysis

Effects of enteral feeding on liver injury after small bowel resection

Effects of enteral feeding on liver injury after small bowel resection

Effects of enteral feeding on liver injury after small bowel resection

Background: The optimal regimen for enteral nutritional support in the management of children with short gut syndrome (SGS) is not well characterized. Elemental formulas do not require as much intestinal digestive and absorptive capacity. However, enteral feeding with a diet high in fat is considered beneficial due greater caloric density and greater structural adaptation. We therefore sought to determine the long-term effects of high fat diet (HFD) on liver steatosis and injury, a common complication of SGS, compared …

Postnatal Gut Immunity and Microbiota Development Is Minimally Affected by Prenatal Inflammation in Preterm Pigs.

Chorioamnionitis (CA), resulting from intra-amniotic inflammation, is a frequent cause of preterm birth and exposes the immature intestine to bacterial toxins and/or inflammatory mediators before birth via fetal swallowing. This may affect intestinal immune development, interacting with the effects of enteral feeding and gut microbiota colonization just after birth. Using preterm pigs as model for preterm infants, we hypothesized that prenatal exposure to gram-negative endotoxin influences postnatal bacterial colonization and gut immune development. Pig fetuses were given intra-amniotic lipopolysaccharide (LPS) 3 days before preterm delivery by cesarean section and were compared with littermate controls (CON) at birth and after 5 days of formula feeding and spontaneous bacterial colonization. Amniotic fluid was collected for analysis of leukocyte counts and cytokines, and the distal small intestine was analyzed for endotoxin level, morphology, and immune cell counts. Intestinal gene expression and microbiota were analyzed by transcriptomics and metagenomics, respectively. At birth, LPS-exposed pigs showed higher intestinal endotoxin, neutrophil/macrophage density, and shorter villi. About 1.0% of intestinal genes were affected at birth, and DMBT1, a regulator of mucosal immune defense, was identified as the hub gene in the co-expression network. Genes related to innate immune response (TLR2, LBP, CD14, C3, SFTPD), neutrophil chemotaxis (C5AR1, CSF3R, CCL5), and antigen processing (MHC II genes and CD4) were also affected, and expression levels correlated with intestinal neutrophil/macrophage density and amniotic fluid cytokine levels. On day 5, LPS and CON pigs showed similar sensitivity to necrotizing enterocolitis, endotoxin levels, morphology, immune cell counts, gene expressions, and microbiota composition (except for difference in some low-abundant species). Our results show that CA markedly affects intestinal genes at preterm birth, including genes related to immune cell infiltration. However, a few days later, following the physiological adaptations to preterm birth, CA had limited effects on intestinal structure, function, gene expression, bacterial colonization, and necrotizing enterocolitis sensitivity. We conclude that short-term, prenatal intra-amniotic inflammation is unlikely to exert marked effects on intestinal immune development in preterm neonates beyond the immediate neonatal period.

Feasibility, tolerance and effectiveness of enteral feeding in critically ill patients in prone position.

To assess the feasibility, tolerance and effectiveness of enteral nutrition in critically ill patients receiving invasive mechanical ventilation in the prone position for severe Acute Respiratory Distress Syndrome (ARDS). Prospective observational study conducted in a multidisciplinary critical care unit of a tertiary care hospital from January 2013 until July 2015. All patients with ARDS who received invasive mechanical ventilation in prone position during the study period were included. Patients' demographics, severity of illness (Acute Physiology and Chronic Health Evaluation (APACHE II) score), baseline markers of nutritional status (subjective global assessment (SGA) and body mass index), details of nutrition delivery during prone and supine hours and outcomes (Length of stay and discharge status) were recorded. Fifty-one patients met inclusion criteria out of whom four patients were excluded from analysis since they did not receive any enteral nutrition due to severe hemodynamic instability. The mean age of patients was 46.4 ± 12.9 years, with male:female ratio of 7:3. On admission, SGA revealed moderate malnutrition in 51% of patients and the mean APACHE II score was 26.8 ± 9.2. The average duration of prone ventilation per patient was 60.2 ± 30.7 h. All patients received continuous nasogastric/orogastric feeds. The mean calories (kcal/kg/day) and protein (g/kg/day) prescribed in the supine position were 24.5 ± 3.8 and 1.1 ± 0.2 while the mean calories and protein prescribed in prone position were 23.5 ± 3.6 and 1.1 ± 0.2, respectively. Percentage of prescribed calories received by patients in supine position was similar to that in prone position (83.2% vs. 79.6%; P = 0.12). Patients received a higher percentage of prescribed protein in supine compared to prone position (80.8% vs. 75%, P = 0.02). The proportion of patients who received at least 75% of the caloric and protein goals was 37 (78.7%) and 37 (78.7%) in supine and 32 (68.1%) and 21 (44.6%) in prone position. In critically ill patients receiving invasive mechanical ventilation in the prone position, enteral nutrition with nasogastric/orogastric feeding is feasible and well tolerated. Nutritional delivery of calories and proteins in prone position is comparable to that in supine position.

PO-0471 Neonatal Arousal And Home-cage Activity Are Feeding-dependent In Preterm Pi

Background and aims Preterm infants exhibit delayed neonatal arousal and impaired motor function. Impaired neuromuscular development, probably interacting with gut and metabolic dysfunctions, may explain this. Using preterm pigs as models, we hypothesised that early initiation of enteral feeding stimulates both gut growth and neonatal arousal and physical activity. Methods Experiment 1: Caesarean-delivered preterm and term pigs were fed parenteral nutrition (PN) or PN plus enteral bovine colostrum (BC) for five days. Other preterm pigs were fed PN with or without BC or formula for five days (Experiment 2), or increasing doses of BC, formula or human milk (HM) for 10 days (Experiment 3). Daily energy intake was matched among the groups in each experiment and home cage activity (HCA) was recorded by continuous camera surveillance. Results Prematurity at birth delayed eye lid opening, first stand and walk, and reduced relative intestinal weight and HCA (Experiment 1, all p Conclusions Prematurity decreased physical activity and relative gut weight within the first week after birth. Small volumes of enteral feeds increased the activity. This may result from general metabolic effects of enteral feeding but could also reflect a direct diet-dependent, gut-neuromuscular maturation in preterm neonates fed enterally. The results support the importance of early enteral feeding of preterm infants with adequate amounts of an optimal diet.

Effect of enteral feeding with ginger extract in acute respiratory distress syndrome

PurposeThe purpose of this study is to evaluate the effects of an enteral diet enriched with ginger extract on inflammatory factors, respiratory profile, and outcome of patients with acute respiratory distress syndrome (ARDS). Materials and methodsThirty-two patients with ARDS were randomized to receive a high-protein enteral diet enriched with ginger or placebo. Serum levels of interleukin (IL) 1, IL-6, tumor necrosis factor α, and leukotriene B4; red blood cell glutathione; oxygenation; and static compliance were measured on days 0, 5, and 10. ResultsPatients fed enteral diet enriched with ginger had significantly lower serum levels of IL-1, IL-6, and tumor necrosis factor α and higher level of RBC glutathione on days 5 and 10 compared with control group (P < .05). Significant improvement in oxygenation was observed on day 5 (P = .02) and 10 (P = .003) in ginger group compared with control group. Static compliance was increased on day 5 (P = .01) in ginger group compared with control group. A significant difference was found in duration of mechanical ventilation (P = .02) and length of intensive care unit stay (P = .04) in favor of ginger group. We did not find any difference in barotraumas, organ failure, and mortality between the study groups. ConclusionsAn enteral diet supplemented with ginger in patients with ARDS may be beneficial for gas exchange and could decrease duration of mechanical ventilation and length of stay in intensive care unit.

Effect of enteral feeding on gallbladder function in dogs

Nutritional support in critically ill patients is a fundamental principle of patient care. Little is known about gallbladder motility during the interdigestive phase and in response to enteral feeding. The objective of this study was to investigate the effect of enteral feeding on gallbladder function in dogs. The cholagogue meal (Lipofundin infusion) was applied in four anatomical positions (jejunum, duodenojejunal junction, descending duodenum, stomach) in five healthy Beagle dogs. Gallbladder volume (GBV) was monitored by ultrasonography. Lipofundin infusion given through the feeding tube caused a maximal gallbladder contraction of 9.2% (range 3.7-13.9%) in the jejunum, 16.5% (9.1-22.1%) at the duodenojejunal junction and 26.3% (22.8-29.5%) in the descending duodenum. When the cholagogue meal was given through the mouth, it caused a mean 33.8% (28.6-46.5%) maximum gallbladder contraction in the same animals. In conclusion, we can establish that the ultrasound-guided gallbladder emptying method proved to be a useful technique for monitoring the cholagogue effect of Lipofundin meal applied in different anatomical positions of the intestine. The deeper the position of application, the smaller and shorter gallbladder contraction was evoked.

The effects of enteral feeding with eicosapentaenoic acid, .GAMMA.-linolenic acid and antioxidant vitamins on mechanically ventilated patients with severe sepsis and septic shock: a retrospective analysis of Japanese-descendant patients

The effects of enteral feeding with eicosapentaenoic acid, .GAMMA.-linolenic acid and antioxidant vitamins on mechanically ventilated patients with severe sepsis and septic shock: a retrospective analysis of Japanese-descendant patients

Intestinal Edema: Effect of Enteral Feeding on Motility and Gene Expression

Edema formation, inflammation, and ileus in the intestine are commonly seen in conditions like gastroschisis, inflammatory bowel disease, and cirrhosis. We hypothesized that early enteral feeding would improve intestinal transit. We also wanted to study the impact of early enteral feeding on global gene expression in the intestine. Rats were divided into Sham or Edema +/- immediate enteral nutrition (IEN). At 12 h, small intestinal transit via FITC-Dextran and tissue water were measured. Ileum was harvested for total RNA to analyze gene expression using cDNA microarray with validation using real-time PCR. Data are expressed as mean +/- SEM, n = 4-6 and (*), (**) = P < 0.05 versus all groups using ANOVA. IEN markedly improved intestinal transit with minimal genetic alterations in Edema animals. Major alterations in gene expression were detected in primary, cellular and macromolecular metabolic activities. Edema also altered more genes involved with the regulation of the actin cytoskeleton. Intestinal edema results in impaired small intestinal transit and globally increased gene expression. Early enteral nutrition improves edema-induced impaired transit and minimizes gene transcriptional activity.

Audit to look at the effectiveness of enteral feeding in allogenic bone marrow transplant patients admitted to the bone marrow transplant unit at St. James Hospital in Leeds

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Audit to look at the effectiveness of enteral feeding in allogenic bone marrow transplant patients admitted to the bone marrow transplant unit at St. James Hospital in Leeds

Audit to look at the effectiveness of enteral feeding in allogenic bone marrow transplant patients admitted to the bone marrow transplant unit at St. James Hospital in Leeds

Comparative study on the effect of enteral feeding on blood glucose

Stress hyperglycaemia is common in intensive care patients. There is recent evidence to suggest that maintaining the blood glucose of a patient in intensive care between 4 mmol/litre and 6.1 mmol/litre reduces morbidity and mortality. The aim of this comparative study was to determine if blood glucose control improves with abolishing feeding breaks and introducing continuous enteral feeding. Twenty ventilated patients admitted to a combined medical and surgical intensive care unit were sampled. Ten patients received standard care (enteral feeding for 18 hours with an 8-hour break). The interventional group received continuous enteral feeding over the 24 hours. Analysis of the data revealed that continuous enteral feeding reduced blood glucose levels significantly, improved blood glucose control and reduced insulin requirements. Research should continue to determine if the results of this study could be replicated within a larger group of intensive care patients.

Effects of enteral feeding with eicosapentaenoic acid, γ-linolenic acid, and antioxidants in mechanically ventilated patients with severe sepsis and septic shock

Effects of enteral feeding with eicosapentaenoic acid, γ-linolenic acid, and antioxidants in mechanically ventilated patients with severe sepsis and septic shock

Effects of enteral feeding with eicosapentaenoic acid, γ-linolenic acid, and antioxidants in mechanically ventilated patients with severe sepsis and septic shock*

Enteral diets enriched with eicosapentaenoic acid (EPA), gamma-linolenic acid (GLA), and antioxidants have previously been shown to improve outcomes in patients with acute respiratory distress syndrome. Several studies using animal models of sepsis demonstrate that enteral nutrition enriched with omega-3 fatty acids reduces mortality rate. This study investigated whether an enteral diet enriched with EPA, GLA, and antioxidant vitamins can improve outcomes and reduce 28-day all-cause mortality in patients with severe sepsis or septic shock requiring mechanical ventilation. Prospective, double-blind, placebo-controlled, randomized trial. Three different intensive care units of a tertiary hospital in Brazil. The study enrolled 165 patients. Patients were randomized to be continuously tube-fed with either a diet enriched with EPA, GLA, and elevated antioxidants or an isonitrogenous and isocaloric control diet, delivered at a constant rate to achieve a minimum of 75% of basal energy expenditure x 1.3 during a minimum of 4 days. Patients were monitored for 28 days. Patients who were fed with the study diet experienced a significant reduction in mortality rate compared with patients fed with the control diet, the absolute mortality reduction amounting to 19.4% (p = .037). The group who received the study diet also experienced significant improvements in oxygenation status, more ventilator-free days (13.4 +/- 1.2 vs. 5.8 +/- 1.0, p < .001), more intensive care unit (ICU)-free days (10.8 +/- 1.1 vs. 4.6 +/- 0.9, p < .001), and a lesser development of new organ dysfunctions (p < .001). In patients with severe sepsis or septic shock and requiring mechanical ventilation and tolerating enteral nutrition, a diet enriched with EPA, GLA, and elevated antioxidants contributed to better ICU and hospital outcomes and was associated with lower mortality rates.

The effects of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid and antioxidants in patients with sepsis

Nutritional support with diets containing eicosapentaenoic acid (EPA), gamma-linolenic acid (GLA) and antioxidants can improve lung microvascular permeability, oxygenation and cardiopulmonary function, by modulating proinflammatory eicosanoid (leukotriene B4, prostaglandin E, thromboxane B2) production from arachdonic acid [1]. This kind of enteral diet can improve gas exchange and clinical outcomes in comparison with a standard control diet in patients with ARDS [2]. The scope of this study is to investigate whether an enteral diet enriched with EPA, GLA and elevated antioxidants can improve outcomes and reduce all-cause mortality in patients with sepsis.

The effects of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid and antioxidants in patients with sepsis

The effects of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid and antioxidants in patients with sepsis

Gastric Tonometry and Enteral Nutrition: a Possible Conflict in Critical Care Nursing Practice

Gastric tonometry is used to assess gastrointestinal mucosal perfusion in critically ill patients. However, enteral feeding is withheld during monitoring with gastric tonometry because enteral feeding is thought to influence tonometric measurements. To examine the effect of enteral feeding on the tonometric measurement of gastric mucosal carbon dioxide. Gastric tonometers were placed in 20 critically ill patients, and the PCO2 of the gastric mucosa was measured in both the full and the empty stomach during a 48-hour period. The PCO2 measured by the tonometer increased after enteral feeding, and a significant difference in the PCO2 of the full versus the empty stomach was evident at 24 and 48 hours. PCO2 at 4, 24, and 48 hours differed significantly in the full stomach and in the empty stomach. However, the data did not reveal a significant difference in either the full stomach or the empty stomach between PCO2 at 24 hours and PCO2 at 48 hours. After 24 hours of feeding, the initial increase in PCO2 observed at 4 hours was not evident, suggesting stabilization of the intragastric environment. However, a higher PCO2 was evident in the empty stomach, indicating that the presence of the feeding solution may reduce the diffusion of carbon dioxide into the tonometer balloon. Consequently, measurements of intragastric PCO2 obtained after 24 hours of feeding may be reliable if the stomach is emptied by aspiration via the tonometer immediately before measurement.

Investigation into the effects of enteral feeding on gastric tonometry monitoring using the saline technique and the Tonocap

Investigation into the effects of enteral feeding on gastric tonometry monitoring using the saline technique and the Tonocap