The effects of enteral stimulation on gallbladder bile during total parenteral nutrition in the neonatal piglet.
The neonatal piglet is a satisfactory model for the human neonate requiring total parenteral nutrition (TPN). Bile status and subsequent liver and gallbladder dysfunction have long been documented as serious complications of long-term TPN. The purpose of this study was to determine whether small amounts of enteral formula during TPN will maintain normal bile appearance and composition. Thirty-one Hanford miniswine, 3 to 6 days old underwent surgery for the placement of central venous catheters. Two days postoperatively, the animals were separated into three groups, according to dietary regimens. Group 1 (n = 10), the control group, received pig formula (SPF-lac) orally (200 cal/kg/d); group 2 (n = 11), was maintained on TPN (180 cal/kg/d) with an enteral supplement of SPF-lac (20 cal/kg/d); group 3 (n = 10), was maintained on TPN only (200 cal/kg/d). The TPN formula consisted of 35 g/kg/d of glucose, 10 g/kg/d of protein, and 3 g/kg/d of lipid. The animals were maintained on these diets for 6 weeks. At necropsy, gallbladder with bile was weighed and bile volume and appearance was recorded. Chemical analyses was performed on 26 bile samples. Gallbladder weight was significantly decreased in groups 2 and 3 compared with group 1 (P less than .0003, P less than .033, respectively, using Students t test with Bonferoni adjustment). Volume was significantly decreased only in group 2 (P less than .003). Group differentiation in relation to bile appearance was determined by the presence or absence of either bile sludge or crystals.(ABSTRACT TRUNCATED AT 250 WORDS)
Cohen
I T
IT
Department of Surgery, University of Massachusetts Medical Center, Worcester 01655.
Meunier
K M
KM
Hirsh
M P
MP
D000818:Animals; D000831:Animals, Newborn; D001646:Bile / Q000032:analysis*; D002779:Cholestasis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D004032:Diet; D004750:Enteral Nutrition / Q000379:methods*; D005705:Gallbladder Diseases / Q000503:physiopathology / Q000517:prevention & control; D008107:Liver Diseases / Q000503:physiopathology / Q000517:prevention & control; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D013552:Swine