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Noninvasive measurement of intestinal epithelial damage at time of refeeding can predict clinical outcome after necrotizing enterocolitis.
MedLine Citation:
PMID:  23154757     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BackgroundReintroduction of enteral nutrition in neonates with necrotizing enterocolitis (NEC) should take place when the gut is ready. Too early start of oral feeding might lead to disease relapse, whereas prolonged discontinuation of enteral nutrition is associated with impaired gut function and parenteral nutrition-related complications. This study evaluates whether non-invasive urinary measurement of intestinal fatty acid binding protein (I-FABP) at time of re-feeding can predict clinical outcome in neonates with NEC.MethodsUrinary I-FABP concentrations were measured in 21 infants with NEC just before reintroducing enteral nutrition. Poor outcome was defined as unsuccessful reintroduction of enteral feeding, (re)operation for NEC, or death related to NEC after reintroduction of enteral feeding.ResultsMedian urinary I-FABP levels in neonates with poor outcome (n=5) were significantly higher compared to I-FABP levels in neonates with good outcome (n=16) (p<0.01). A clinically significant cut-off value of 963 pg/ml was found to discriminate infants with poor outcome from those with good outcome (sensitivity 80%, specificity 94%).ConclusionNoninvasive urinary I-FABP measurement at time of re-feeding differentiates neonates with poor outcome from neonates with good outcome in NEC. Urinary I-FABP measurement may therefore be helpful in the timing of enteral feeding in neonates with NEC.Pediatric Research (2012); doi:10.1038/pr.2012.160.
Authors:
Kostan W Reisinger; Joep P M Derikx; Geertje Thuijls; David C van der Zee; Hens A A Brouwers; Annemarie A van Bijnen; Tim G A M Wolfs; L W Ernest van Heurn; Wim A Buurman; Boris W Kramer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-15
Journal Detail:
Title:  Pediatric research     Volume:  -     ISSN:  1530-0447     ISO Abbreviation:  Pediatr. Res.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Surgery, Maastricht University Medical Center, and Nutrition and Toxicology Research Institute (NUTRIM), Maastricht, The Netherlands.
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