Effect of Different Tube Feeding Methods on the Delivery of Docosahexaenoic and Arachidonic Acid: An In Vitro Pilot Study.


Journal

JPEN. Journal of parenteral and enteral nutrition
ISSN: 1941-2444
Titre abrégé: JPEN J Parenter Enteral Nutr
Pays: United States
ID NLM: 7804134

Informations de publication

Date de publication:
05 2019
Historique:
received: 07 06 2018
revised: 17 08 2018
accepted: 22 08 2018
pubmed: 28 9 2018
medline: 12 9 2020
entrez: 28 9 2018
Statut: ppublish

Résumé

Arachidonic acid (AA) and docosahexaenoic acid (DHA) are crucial for neural and visual development after premature birth. Preterm infants usually require tube feeding (TF) until the achievement of adequate oral feeding skills; the impact of TF on DHA and AA delivery has not been investigated yet. This study aimed to evaluate the effect of different TF techniques on the delivery of AA and DHA contained in human milk (HM). HM samples (65 mL each) were collected and divided into three 20-mL aliquots. The remaining 5 mL served as baseline. Three TF techniques were simulated (1 for each aliquot): gravity bolus feeding (BF), 3-hour continuous feeding using a horizontal feeding pump, and 3-hour continuous feeding with the feeding pump angled at 45°. For horizontal continuous feeding (HCF) and 45° angled continuous feeding (ACF), aliquots delivered between 0 and 90 minutes (T1) and 91 and 180 minutes (T2) were collected separately. AA and DHA concentration was analyzed by gas chromatography/mass spectrometry and compared among the TF methods. DHA and AA delivery at T1 and T2 was also evaluated. Fifty-one simulated feeds were performed. DHA and AA amounts after BF and ACF did not differ significantly compared with baseline, whereas HCF resulted in significantly lower DHA and AA concentration. During T2, ACF delivered almost twice the DHA and AA amounts compared with T1. The delivery of HM AA and DHA is significantly affected by TF, with potential clinical implications. When BF is not tolerated, ACF might represent a feasible alternative to reduce TF-related DHA and AA loss.

Sections du résumé

BACKGROUND
Arachidonic acid (AA) and docosahexaenoic acid (DHA) are crucial for neural and visual development after premature birth. Preterm infants usually require tube feeding (TF) until the achievement of adequate oral feeding skills; the impact of TF on DHA and AA delivery has not been investigated yet. This study aimed to evaluate the effect of different TF techniques on the delivery of AA and DHA contained in human milk (HM).
METHODS
HM samples (65 mL each) were collected and divided into three 20-mL aliquots. The remaining 5 mL served as baseline. Three TF techniques were simulated (1 for each aliquot): gravity bolus feeding (BF), 3-hour continuous feeding using a horizontal feeding pump, and 3-hour continuous feeding with the feeding pump angled at 45°. For horizontal continuous feeding (HCF) and 45° angled continuous feeding (ACF), aliquots delivered between 0 and 90 minutes (T1) and 91 and 180 minutes (T2) were collected separately. AA and DHA concentration was analyzed by gas chromatography/mass spectrometry and compared among the TF methods. DHA and AA delivery at T1 and T2 was also evaluated.
RESULTS
Fifty-one simulated feeds were performed. DHA and AA amounts after BF and ACF did not differ significantly compared with baseline, whereas HCF resulted in significantly lower DHA and AA concentration. During T2, ACF delivered almost twice the DHA and AA amounts compared with T1.
CONCLUSION
The delivery of HM AA and DHA is significantly affected by TF, with potential clinical implications. When BF is not tolerated, ACF might represent a feasible alternative to reduce TF-related DHA and AA loss.

Identifiants

pubmed: 30260487
doi: 10.1002/jpen.1448
doi:

Substances chimiques

Docosahexaenoic Acids 25167-62-8
Arachidonic Acid 27YG812J1I

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

550-556

Informations de copyright

© 2018 American Society for Parenteral and Enteral Nutrition.

Auteurs

Silvia Martini (S)

Neonatal Intensive Care Unit, St. Orsola-Malpighi University Hospital, Bologna, Italy.
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

Arianna Aceti (A)

Neonatal Intensive Care Unit, St. Orsola-Malpighi University Hospital, Bologna, Italy.
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

Martina Furini (M)

Neonatal Intensive Care Unit, St. Orsola-Malpighi University Hospital, Bologna, Italy.

Alessandra Munarini (A)

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Centre of Applied Biomedical Research, Department of Clinical Medicine, University of Bologna, Bologna, Italy.

Cristina La Riccia (C)

Centre of Applied Biomedical Research, Department of Clinical Medicine, University of Bologna, Bologna, Italy.

Vilma Mantovani (V)

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Centre of Applied Biomedical Research, Department of Clinical Medicine, University of Bologna, Bologna, Italy.

Giacomo Faldella (G)

Neonatal Intensive Care Unit, St. Orsola-Malpighi University Hospital, Bologna, Italy.
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

Luigi Corvaglia (L)

Neonatal Intensive Care Unit, St. Orsola-Malpighi University Hospital, Bologna, Italy.
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

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