Outcomes and Perioperative Nutritional Management in a Porcine Model of Short Bowel Syndrome.

Outcomes and Perioperative Nutritional Management in a Porcine Model of Short Bowel Syndrome.
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DOI:
10.1016/j.jss.2022.01.004
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发表时间:
2022-06
影响因子:
2.2
通讯作者:
Puder, Mark
Puder, Mark
中科院分区:
医学3区
文献类型:
--
作者:
Tsikis, Savas Theodore;Fligor, Scott C.;Secor, Jordan D.;Yu, Lumeng J.;Pan, Amy;Loring, Greta;First, Eric;Nedder, Arthur P.;Grammer, Robin M.;Rudie, Coral;Gura, Kathleen M.;Puder, Mark

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短肠综合症(SBS)是由严重的肠道损失引起的,其特点是营养和液体吸收不足。临床前大型动物 SBS 模型通常需要肠外营养 (PN) 支持,可能不适合研究改善肠道吸收或适应的干预措施。在这里,我们描述了不需要 PN 支持的猪 SBS 模型的开发。八只雄性约克夏仔猪接受了 75% 或 90% 空肠切除术 (n=5) 或不切除 (n=3)。通过胃造口管提供持续肠内营养(EN)。最终的 SBS 模型包括 75% 的切除,并通过组合 EN (60%) 和口服猪饲料 (40%) 提供营养。在术后第 7 天、第 14 天和第 21 天评估体重和脂溶性维生素浓度。为了评估脂肪吸收不良,在收集 72 小时粪便后计算脂肪吸收系数 (CFA)。与未切除的对照组相比,切除的动物体重增加减少(POD21 +8.3% vs. +28.8%,P=0.048)。与 POD 7、POD 14 和 POD 21 的对照组相比,切除动物的维生素 D 浓度显着降低。POD 21 的血清维生素 E 浓度也较低。切除的动物出现脂肪吸收不良,CFA 较低(76.5% vs. 95.3%,P=0.014)。我们描述了不需要 PN 支持的猪 SBS 模型的开发。该模型中的仔猪体重增加较少,表现出脂肪吸收不良,并出现脂溶性维生素缺乏症。该模型将有利于肠道吸收或适应的研究,同时可能降低与 PN 给药相关的成本和混淆并发症。
Short bowel syndrome (SBS) results from significant intestinal loss and is characterized by insufficient absorption of nutrients and fluids. Preclinical large animal SBS models typically require parenteral nutrition (PN) support and may not be appropriate for studying interventions to improve intestinal absorption or adaptation. Here, we describe development of a porcine SBS model that does not require PN support. Eight male Yorkshire piglets underwent either a 75% or 90% jejunoileal resection (n=5) or no resection (n=3). Continuous enteral nutrition (EN) was provided via gastrostomy tube. The final SBS model consisted of a 75% resection, and nutrition provided via combination EN (60%) and per oral pig chow (40%). Body weight and concentration of fat-soluble vitamins were assessed on post-operative days (POD) 7, 14, and 21. To assess fat malabsorption, the coefficient of fat absorption (CFA) was calculated following a 72-hour stool collection. Resected animals had decreased weight gain compared to unresected controls (POD21 +8.3% vs. +28.8%, P=0.048). Vitamin D concentration was significantly lower in resected animals compared to controls on POD 7, POD 14, and POD 21. Serum vitamin E concentration was also lower on POD 21. Resected animals developed fat malabsorption with lower CFA (76.5% vs. 95.3%, P=0.014). We describe the development of a porcine SBS model that does not require PN support. Piglets in this model gain less weight, demonstrate fat malabsorption, and develop fat-soluble vitamin deficiencies. This model will benefit investigations of intestinal absorption or adaptation, while potentially decreasing costs and confounding complications related to PN administration.
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发表时间: 2019-09-01
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