title: The Fate of Fat: Pre-Exposure Fat Losses during Nasogastric Tube Feeding in Preterm Newborns.
abstract: Deficient nutritional support and subsequent postnatal growth failure are major covariates of short- and long-term outcome in preterm neonates. Despite its relevance, extrauterine growth restriction (EUGR) is still prevalent, occurring in an important portion of extremely preterm infants. Lipids provide infants with most of their energy needs, but also cover specific supplies critical to growth, development and health. The use of human milk in preterm neonates results in practices, such as milk storage, pasteurization and administration by an infusion system. All of these pre-exposure manipulations significantly affect the final extent of lipid deposition in the intestinal track available for absorption, but the impact of tube feeding is the most significant. Strategies to shift earlier to oral feeding are available, while adaptations of the infusion systems (inversion, variable flow) have only more recently been shown to be effective in "in vitro", but not yet in "in vivo" settings. Pre-exposure-related issues for drugs and nutritional compounds show similarities. Therefore, we suggest that the available practices for "in vitro" drug evaluations should also be considered in feeding strategies to further reduce pre-exposure losses as a strategy to improve the nutritional status and outcome of preterm neonates.
authors.affiliation: Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium. maissa.rayyan@uzleuven.be.|Neonatal Intensive Care Unit, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium. maissa.rayyan@uzleuven.be.
authors.forename: Maissa
authors.initials: M
authors.lastname: Rayyan
authors.affiliation: Translational Research Center for Gastrointestinal Diseases, KU Leuven, 3000 Leuven, Belgium. nathalie.rommel@med.kuleuven.be.|Neuro-gastroenterology and Motility, Gastroenterology, 3000 Leuven, Belgium. nathalie.rommel@med.kuleuven.be.|Neurosciences, Exp ORL, KU Leuven, Herestraat 49, O & N 2, PO Box 79, 3000 Leuven, Belgium. nathalie.rommel@med.kuleuven.be.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Rommel
authors.affiliation: Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium. karel.allegaert@uzleuven.be.|Neonatal Intensive Care Unit, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium. karel.allegaert@uzleuven.be.
authors.forename: Karel
authors.initials: K
authors.lastname: Allegaert
mesh_terms: D004041:Dietary Fats / Q000008:administration & dosage; D004750:Enteral Nutrition / Q000009:adverse effects*; D006130:Growth Disorders / Q000209:etiology*; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007441:Intubation, Gastrointestinal; D008055:Lipids / Q000008:administration & dosage*; D008895:Milk, Human / Q000737:chemistry*; D009752:Nutritional Status; D061352:Pasteurization
chemical_list: D004041:Dietary Fats; D008055:Lipids
keywords: absorption; fat delivery; lipids; nasogastric tube feeding; nutritional support; preterm