Jain Ajay K, Wen Joy X, Arora Sumit, Blomenkamp Keith S, Rodrigues Jonathan, Blaufuss Timothy A, Liou Victor, Burrin Douglas G, Long John P, Teckman Jeffery H
St Louis University School of Medicine, Cardinal Glennon Children's Medical Center, 1465 South Grand Blvd., St. Louis, MO 63104, USA.
St Louis University School of Medicine, Cardinal Glennon Children's Medical Center, 1465 South Grand Blvd., St. Louis, MO 63104, USA.
Nutr Res. 2015 Feb;35(2):169-74. doi: 10.1016/j.nutres.2014.12.004. Epub 2014 Dec 31.
Total parenteral nutrition (TPN) provides all nutrition intravenously. Although TPN therapy has grown enormously, it causes significant complications, including gut and hepatic dysfunction. Current models use animal tethering which is unlike ambulatory human TPN delivery and is cost prohibitive. We hypothesize that using ultramobile infusion pumps, TPN can be delivered cost-effectively, resulting in classical gut and hepatic injury, and we thus aim to establish a new model system. Neonatal pigs (n=8) were implanted with jugular vein and duodenal catheters. Animals were fitted in dual-pocket jackets. An ultramobile ambulatory pump was placed in one pocket and connected to the jugular vein or duodenal catheter. Isocaloric TPN or swine formula was placed in the other pocket. Rigorous Wifi-based video and scheduled monitoring was performed. After 14days, the animals were euthanized. The mean (±SD) daily weight gain (in grams) for enteral-fed control (EN) vs TPN animals was 102.4±10.8 and 91.03±12.1 respectively (P<.05). Total parenteral nutrition resulted in significant conjugated bilirubin elevation and hepatomegaly. Mean (±SD) serum conjugated bilirubin (in μmol/L) was 1.5±0.7 for EN and 6.3±2.8 for TPN (P<.05). Marked gut atrophy was noted with TPN. The mean (±SD) gut weight as a percent of body weight was 4.30±0.26 for EN and 2.62±0.48 for TPN (P<.05). Surgical sites healed well. All animals remained completely mobile. We thus established that TPN can be successfully delivered using ultramobile pumps and believe that this remains the first such description of an ambulatory piglet TPN model system. In addition to cholestasis and gut atrophy, classical TPN-induced injury was documented.
全胃肠外营养(TPN)通过静脉途径提供所有营养。尽管TPN疗法已得到极大发展,但它会引发包括肠道和肝功能障碍在内的严重并发症。目前的模型使用动物束缚法,这与非卧床的人类TPN给药不同,且成本高昂。我们假设使用超便携式输液泵,可以经济高效地进行TPN给药,从而导致典型的肠道和肝脏损伤,因此我们旨在建立一种新的模型系统。对8只新生猪植入颈静脉和十二指肠导管。给动物穿上双口袋夹克。将一个超便携式非卧床泵放在一个口袋里,并连接到颈静脉或十二指肠导管。等热量的TPN或猪配方奶放在另一个口袋里。通过基于无线网络的严格视频和定期监测进行观察。14天后,对动物实施安乐死。肠内喂养对照组(EN)与TPN组动物的平均(±标准差)每日体重增加量(以克为单位)分别为102.4±10.8和91.03±12.1(P<0.05)。全胃肠外营养导致结合胆红素显著升高和肝脏肿大。EN组和TPN组的平均(±标准差)血清结合胆红素(以μmol/L为单位)分别为1.5±0.7和6.3±2.8(P<0.05)。TPN组出现明显的肠道萎缩。EN组和TPN组肠道重量占体重的平均(±标准差)百分比分别为4.30±0.26和2.62±0.48(P<0.05)。手术部位愈合良好。所有动物保持完全活动能力。因此,我们证实使用超便携式泵可以成功进行TPN给药,并认为这是首次对非卧床仔猪TPN模型系统的此类描述。除胆汁淤积和肠道萎缩外,还记录了典型的TPN诱导损伤。
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