Poster Topical Area: Maternal, Perinatal and Pediatric Nutrition

Location: Hall D

Poster Board Number: 262

P13-003 - Evaluation of an Enteral Complex Lipid Emulsion to Prevent Fatty Acid Deficits in Preterm Infants using a Preterm Piglet Model

Sunday, Jun 10
8:00 AM – 6:00 PM

Objectives
Docosahexaenoic acid (DHA) and arachidonic acid (AA) decline in preterm infants within the first postnatal week with the current standard of nutritional care. These changes are linked to an increased risk of neonatal morbidities. Our objective was to determine the efficacy of early enteral supplementation of a concentrated lipid emulsion (CLE) containing DHA, AA and specific lipophilic nutrients (lutein, vitamins E & D) in maintaining birth plasma and tissue levels of these nutrients.
Methods
Preterm piglets (gestation ~107d) were randomized at birth to receive either a "control" diet (Sow formula + soybean oil emulsion, n=6) or a "supplemented" diet (Sow formula + CLE, n=7) during an 8-day feeding protocol. Five piglets were sacrificed at birth to establish baseline levels of fatty acids (FA), lutein, and vitamins E and D. Blood samples were collected on days 2,4,6, and 8 to quantify FA changes as a function of diet. On Day 8 tissues were collected for FA and lipophilic nutrient analyses.
Results
Mean baseline plasma DHA levels at birth were similar in the control and supplemented groups (2.6 ± .6 and 2.8 ± .8 mol%, respectively). By day 2, the supplemented group maintained plasma DHA levels while the control piglets experienced a DHA deficit compared to baseline (3.9±.6 vs 1.2±.1 mol%, respectively; p=0.00001). Differences in DHA between groups remained throughout the 8-day feeding protocol. In contrast, both groups demonstrated a decline in AA from birth, though the supplemented group had slightly higher levels (9.5±1 vs 8.3±.6 mol%, respectively; p=0.047). Similar changes in DHA and AA levels between groups were shown in brain and ileum. Lutein and vitamins E and D showed higher increases from baseline in plasma and tissues of the supplemented piglets compared to controls; lutein increased significantly in eye, liver, lung, ileum and colon; vitamin E increased in plasma, proximal ileum and frontal cortex; and vitamin D3 increased in plasma, proximal ileum, liver and lung.
Conclusions
Early enteral delivery of CLE was well tolerated in preterm piglets and was able to minimize the postnatal deficiencies of systemic DHA. Significant accretion of DHA, lutein and vitamins E and D in plasma and in important tissues was also demonstrated.




Funding Source: Abbott Nutrition
Harvard Catalyst | The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health Award UL1 TR001102) and financial contributions from Harvard University and its affiliated academic healthcare centers.
Charles H. and Judy Hood Family Infant Health Research Program
NIH R01 DK104346

CoAuthors: George Perides – Beth Israel Deaconess Medical Center; Lorenzo Anez-Bustillos – Boston Children's Hospital; Xinting Yu – Beth Israel Deaconess Medical Center; Arthur Nedder – Boston Children's Hospital ARCH; Elizabeth Pollack – Boston Children's Hospital ARCH; Joanne Brown – Beth Israel Deaconess Medical Center; Lady Leidy Sanchez-Fernandez – Beth Israel Deaconess Medical Center; Evelyn Obregon – Beth Israel Deaconess Medical Center; Ece Bicak – Beth Israel Deaconess Medical Center; Mustafa Vurma – Research and Development, Abbott Nutrition, Abbott Laboratories; Stefan Ehling – Research and Development, Abbott Nutrition, Abbott Laboratories; Douglas Gordon – Research and Development, Abbott Nutrition, Abbott Laboratories; Stephen DeMichele – Research and Development, Abbott Nutrition, Abbott Laboratories; Steven Freedman – Beth Israel Deaconess Medical Center; Camilia Martin – Beth Israel Deaconess Medical Center

Olajumoke Akinsulire

Medical Student
Brown Alpert Medical School
Providence, Rhode Island