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A Comparison of Parenteral and Enteral Feeding in Neonatal Piglets, Including an Assessment of the Utilization of a Glutamine‐Rich, Pediatric Elemental Diet
Author(s) -
Bertolo Robert F. P.,
Pencharz Paul B.,
Ball Ronald O.
Publication year - 1999
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/014860719902300247
Subject(s) - glutamine , parenteral nutrition , enteral administration , valine , amino acid , elemental diet , medicine , nitrogen balance , isoleucine , zoology , chemistry , biology , biochemistry , leucine , nitrogen , organic chemistry
Background: The amino acid requirement profile for infants is different than that for adults and needs to be established; this profile also is different for infants receiving total parenteral nutrition. We used the neonatal piglet as a model for the infant to address (1) the metabolic and physiologic changes due to route of feeding and (2) the adequacy of the amino acid pattern in a pediatric elemental diet. Methods: Diets differed only in their amino acid pattern (modified human milk [MHM] and a commercial pediatric elemental diet [PED]) and were fed continuously for 8 days. Control piglets were fed MHM diet via gastric catheters (IG) and were compared with pigs fed MHM diet via venous catheters (IV) or to pigs IG‐fed PED. Results: MHM‐IV piglets experienced enlarged livers and gut atrophy, and lower nitrogen retention and body protein content. Higher glutamine (and lower glutamate) in PED‐IG, compared with MHM‐IG, produced no apparent advantage with respect to gut growth or histology. Proline, histidine, and lysine may have been limiting, and isoleucine and valine excessive, in the PED‐IG diet as indicated by plasma concentrations, compared with sow‐fed piglets; however, imbalances in the amino acid profile were not excessive because nitrogen retention was not different between MHM‐IG or PED‐IG pigs. Conclusions: Therefore, the amino acid profile of MHM needs to be modified to improve nitrogen retention during parenteral feeding and the profile of oral PED could be improved to normalize plasma amino acid concentrations. (Journal of Parenteral and Enteral Nutrition 23:47–55, 1999)