Endotoxin content in neonatal formulas, fortification, and lactoferrin products: association with outcomes and guidance on acceptable limits.
Endotoxin content in neonatal formulas, fortification, and lactoferrin products: association with outcomes and guidance on acceptable limits.
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DOI：
10.1007/s10534-022-00487-1
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发表时间：
2023-06
期刊：
影响因子：
3.5
通讯作者：
Jensen, David
中科院分区：
文献类型：
--
作者：
Kaufman, David A.;Perks, Patti H.;Greenberg, Rachel G.;Jensen, David
虽然内毒素（脂多糖）可能是有害的，并导致早产儿革兰氏阴性脓毒症或坏死性小肠结肠炎的发病率和死亡率，但无毒量作为新生儿微生物组的一部分产生，并可能存在于肠内营养和给予的药物中。美国食品药品监督管理局已经给出了静脉药物和液体的内毒素浓度限值为5个内毒素单位/kg/小时（120个内毒素单位/kg/天）的指南，但没有给出肠内产品中内毒素含量的指南。为了确定新生儿重症监护室中婴儿的基线暴露，我们检查了早产儿肠内配方奶粉和强化食品以及牛乳铁蛋白产品的内毒素含量。我们还研究了极低出生体重儿的内毒素暴露和结局。采用动态显色鲎试剂分析法测定内毒素含量。来自肠内配方的每日内毒素暴露范围在< 75至7110内毒素单位/kg之间，来自乳铁蛋白产品的每日内毒素暴露范围在7至3720内毒素单位/kg之间。在检查以三种不同递增剂量（100、200和300 mg/kg/天）研究的牛乳铁蛋白产品的新生儿结局时，我们测量了乳铁蛋白产品中的内毒素，每日暴露量分别为1089（N = 10）、2178（N = 10）和3287（N = 11）内毒素单位/kg。在这些患者中没有坏死性小肠结肠炎或死亡病例，也没有乳铁蛋白相关的不良反应。乳铁蛋白产品的肠内毒素每日暴露量与早产儿肠内营养的量相似，并且似乎是安全的，与患者伤害无关。测试肠内产品和建立安全限值可以改善高危患者的护理。在线版本包含补充材料，可通过10.1007/s10534-022-00487-1获取。
While endotoxin (lipopolysaccharide) can be harmful and contribute to morbidity and mortality with Gram-negative sepsis or necrotizing enterocolitis in preterm infants, non-toxic amounts are produced as part of the neonatal microbiome and may be present in enteral nutrition and medications administered. The United States Food and Drug Administration has given guidance for endotoxin concentration limits for intravenous medications and fluids of 5 endotoxin units/kg/hour (120 endotoxin units/kg/day), but no guidance for amounts of endotoxin in enteral products. To determine baseline exposure to infants in the neonatal intensive care unit, we examined endotoxin content of enteral formulas and fortification used for preterm infants, as well as bovine lactoferrin products. We also examined endotoxin exposure and outcomes in very low birth weight infants. Endotoxin content was measured using kinetic chromogenic limulus amebocyte lysate analysis. Daily endotoxin exposure from enteral formulas ranged between < 75 to 7110 endotoxin units/kg and from lactoferrin products from 7 to 3720 endotoxin units/kg. In examining neonatal outcomes from a bovine lactoferrin product studied at three different escalating doses (100, 200, and 300 mg/kg/day), we measured endotoxin in the lactoferrin product and daily exposure was 1089 (N = 10), 2178 (N = 10) and 3287 (N = 11) endotoxin units/kg, respectively. There were no cases of necrotizing enterocolitis or mortality and no lactoferrin-related adverse effects in these patients. Enteral endotoxin daily exposures from lactoferrin products are similar to amounts in preterm enteral nutrition and appear safe and not associated with patient harm. Testing enteral products and establishing safety limits may improve care of high risk patients. The online version contains supplementary material available at 10.1007/s10534-022-00487-1.
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影响因子：
5.3
作者：
Townsend, Stacy;Barron, Juncal Caubilla;Forsythe, Stephen
通讯作者：
Forsythe, Stephen
影响因子：
5.9
作者：
Sochaczewska D;Ziętek M;Dołęgowska B;Kordek A;Szczuko M
通讯作者：
Szczuko M
DOI：
10.1164/rccm.200810-1533oc
发表时间：
2009-03-01
影响因子：
24.7
作者：
Smit, Lidwien A. M.;Siroux, Valerie;Kauffmann, Francine
通讯作者：
Kauffmann, Francine
影响因子：
3.5
作者：
VANSLOOTEN, JC;BHUVANASVARI, TV;STANLEY, J
通讯作者：
STANLEY, J
DOI：
10.1007/s10024-002-0602-z
发表时间：
2003-01
期刊：
Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society
影响因子：
--
作者：
Hsueh W;Caplan MS;Qu XW;Tan XD;De Plaen IG;Gonzalez-Crussi F
通讯作者：
Gonzalez-Crussi F