Introduction of enteral feeding in neonates on extracorporeal membrane oxygenation after evaluation of intestinal permeability changes

Piena, Marjolein; Albers, Marcel J. I. J.; Haard, P.M.M. van; Gischler, Saskia J.; Tibboel, Dick

doi:10.1016/s0022-3468(98)90355-4

Cited by 53 publications

(47 citation statements)

References 19 publications

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“…The underlying variation in PK parameters could not be explained by age, body weight, time after ECMO decannulation or other covariates, which might have been caused by the relatively narrow age and weight range: most patients were between 10 and 22 days old. Variable gut absorption might in part be responsible, which has thus far been described for enteral feeding only 17. Another explanation could be flow-limited hepatic clearance in combination with haemodynamic changes, even though SIL is considered to have an intermediate extraction ratio in healthy adults 18.…”

Section: Discussionmentioning

confidence: 99%

Sildenafil exposure in neonates with pulmonary hypertension after administration via a nasogastric tube

Ahsman

Witjes

Wildschut

et al. 2009

Archives of Disease in Childhood - Fetal and Neonatal Edition

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SIL pharmacokinetics are highly variable in post-ECMO neonates and infants. In a median patient, the current dose regimen of 0.5-2.0 mg/kg four times a day leads to an exposure comparable to the recommended adult dose of 20 mg four times a day. Careful dose titration, based on efficacy and the occurrence of hypotension, remains necessary. Follow-up research should include appropriate pharmacodynamic endpoints, with a population pharmacokinetic/pharmacodynamic analysis to assign a suitable exposure window or target concentration.

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Section: Discussionmentioning

confidence: 99%

Sildenafil exposure in neonates with pulmonary hypertension after administration via a nasogastric tube

Ahsman

Witjes

Wildschut

et al. 2009

Archives of Disease in Childhood - Fetal and Neonatal Edition

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“…It has been suggested that increased mucosal permeability may be an early event in the pathogenesis of NEC, allowing for translocation of bacteria, recruitment of polymorphonuclear leukocytes, and consequent tissue destruction [8,9]. Key factors in NEC pathogenesis, such as hypoxia/reoxygenation, and the production of platelet activating factor, tumor necrosis factor a, and endotoxin, have been shown to increase intestinal mucosal permeability [10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Heparin-binding epidermal growth factor–like growth factor decreases the incidence of necrotizing enterocolitis in neonatal rats

Feng¹,

El-Assal²,

Besner³

2006

Journal of Pediatric Surgery

101

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“…Bacterial translocation is a phenomenon that has been shown to occur under many pathological circumstances and diseases such as burn injury, ileus, prolonged hemorrhagic shock, total parenteral nutrition, starvation, cholestasis, and other conditions [22][23][24][25][26]. Several defects of the innate immune system have been discussed as primary common pathogenetic mechanisms, such as hypoperistalsis with intestinal bacterial overgrowth, impaired mucus production or function, lack of bile acids within the intestinal lumen, decreased s-IgA production or intestinal availability, and many others [27][28][29][30][31][32].…”

Section: Discussionmentioning

confidence: 99%

The role of nuclear factor-kappa B in bacterial translocation in cholestatic rats

et al. 2005

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Xanthinoxidase (XO) derived radical species are involved in bacterial translocation (BT) in cholestatic rats. The mechanism by which XO influences remains unclear. It has been shown recently that nuclear factor-kappa B (NF-kappaB), a ubiquitous transcription factor, can be activated by oxidative stress and thereby promote the process of BT. We investigated the effects of NF-kappaB inactivation on the incidence of BT in cholestatic rats. Sprague-Dawley rats were randomly assigned to one of eight groups: groups 1-4 were sham laparotomized rats either untreated (S1) or treated for 5 days with thalidomide (S2), curcumin (S3), or Inchin-ko (ICK; S4); groups 5-8 underwent common bile duct ligation (CBDL) for 5 days and were either untreated (C1) or treated with thalidomide (C2), curcumin (C3), or ICK (C4). After 5 days bacteriological cultures were performed from portal blood and V. cava, from the central mesenteric lymph node complex (MLN), spleen, and liver. The intensity of the activated NF-kappaB-subunit p65/p50 in the ileum mucosa was estimated by light microscopy and a scoring system from 1 to 20. Malondialdehyde (MDA) and myeloperoxidase activity (MPO) in the ileum were evaluated and expressed as U/g dry weight. Thalidomide and ICK reduced in CBDL-rats significantly the BT rate (63% vs. 18%, 63% vs. 30%, P<0.01). Enzyme estimations (MDA, MPO, and GSH) in sham operated animals showed no significant changes in the untreated groups compared with the treated groups. CBDL-rats pre-treatment with all three compounds caused a significant increase of MDA levels if groups were compared with the untreated C1-group (C1 31.6+/-7.7, C2 54.5+/-12.2, C3 53.3+/-11.2, and C4 47.2+/-9.4). GSH was reduced after the pre-treatment by all compounds but only significantly after curcumin pre-treatment (C1 vs. C3: 13.9+/-1.8 vs. 7.1+/-1.8; P<0.05). MPO estimations were significantly higher in the untreated C1-group if compared with groups C2, C3, and C4 (C1 1036.4+/-340.9, C2 709.9+/-125.9, C3 545.2+/-136.6, and C4 556.7+/-247.4; P<0.05). Thalidomide inhibited significantly the activation of NF-kappaB (C2 vs. C1: 6.0+/-4.5 vs. 12.7+/-5.3; P<0.01). Likewise, Curcumin and ICK suppressed NF-kappaB activation, but this did not reach significance in this experiment. NF-kappaB is involved in the process of BT in cholestatic rats and may be activated by XO derived ROS. We assume that the activated NF-kappaB initiates transcription of target genes inducing cytokine production, which in turn disrupts the tight junctions leading to BT from the intestinal lumen to the MLNs and circulation.

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Introduction of enteral feeding in neonates on extracorporeal membrane oxygenation after evaluation of intestinal permeability changes

Cited by 53 publications

References 19 publications

Sildenafil exposure in neonates with pulmonary hypertension after administration via a nasogastric tube

Sildenafil exposure in neonates with pulmonary hypertension after administration via a nasogastric tube

Heparin-binding epidermal growth factor–like growth factor decreases the incidence of necrotizing enterocolitis in neonatal rats

The role of nuclear factor-kappa B in bacterial translocation in cholestatic rats

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