FEEDING INTOLERANCE IN PREMATURE INFANTS

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 摘要 假设 我们假设，在胎龄25至32周的早产儿中，以下测试： 测量： a. 使用13 C-辛酸呼吸试验测量胃排空; B. 用蔗糖/乳果糖/甘露醇/三氯蔗糖尿排泄（渗透性）试验（PT）测定的胃肠粘膜完整性; c. 使用乳糖酶活性测试（PT的一部分）测量的乳糖酶活性;和d. 钙卫蛋白和α-1-抗胰蛋白酶的粪便排泄（浓度）。 1. 能够在进食不耐受变得临床上明显之前检测到进食不耐受的存在（通过增加的胃残留物、异常的临床腹部检查、绿色胃残留物的存在来定义）;以及2. 可用于预测达到完全肠内喂养所需的时间。 二. 具体目标 我们研究计划的长期目标是减少与胃肠道（GI）发育不全相关的早产不良后果。 与胃肠道不成熟相关的并发症是导致疾病严重程度增加（包括导致死亡）并最终延长住院时间的原因。 我们致力于减轻因胃肠道发育不良而导致的进食问题（不耐受）所带来的情感和经济负担。 本提案的目标是： 1. 发展喂养不耐受的标志物;和2。 检测它们在早期识别喂养不耐受中的敏感性、特异性、阳性预测值和阴性预测值。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. ABSTRACT HYPOTHESIS We hypothesize that in preterm infants 25 to 32 weeks gestational age the following tests: Measurement of: a. Gastric emptying measured using the 13C-octanoic acid breath test; b. Gastrointestinal mucosal integrity determined withthe sucrose/lactulose/mannitol/sucralose urinary excretion (permeability) test (PT); c. Lactase activity measured using the lactase activity test (part of the PT); and d. Fecal excretion (concentrations) of calprotectin and alpha-1-antitrypsin. 1. Can detect the presence of feeding intolerance (defined by increased gastric residuals, abnormal clinical abdominal examination, presence of green gastric residuals) before it becomes clinically apparent; and 2. Can be used to predict the time required to reach full enteral feedings. II. SPECIFIC AIMS The long-term goals of our research program are to reduce the adverse consequences of preterm birth related to underdevelopment of the gastrointestinal (GI) tract. Complications related to GI immaturity are responsible for increasing illness severity (including causing death) and ultimately prolonging hospitalization. We seek to derease the emotional and economic burden related to feeding problems (intolerance) that result from underdevelopment of the GI tract. The objectives of the current proposal are to: 1. Develop markers of feeding intolerance; and 2. Test their sensitivity, specificity, positive and negative predictive value in the early identification of feeding intolerance.