274 - Effect of Feeding Tube Dwell Time on the Gastrointestinal Tract Pro-Inflammatory Cytokine Response

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 274
Publication Number: 274.428

Rebecca Koerner, University of Florida, Land O Lakes, FL, United States; Josef Neu, University of Florida, Gainesville, FL, United States; Monica F Torrez Lamberti, University of Florida, Gainesville, FL, United States; Leslie Parker, University of Florida College of Medicine, Gainesville, FL, United States

Presenting Author(s)

Rebecca Koerner, PhD, APRN, CPNP-PC (she/her/hers)

Postdoctoral Research Associate
University of Florida
Land O Lakes, Florida, United States

Background: Very low birthweight (VLBW) infants often require a feeding tube for weeks to months due to immaturity and/or critical illness. Feeding tubes harbor pathogenic bacteria which enter the infant’s gastrointestinal tract (GIT) with each feeding and may cause gastrointestinal inflammation. Bacterial growth is known to increase over time thus the length of time feeding tubes remain in place may increase the risk of GIT dysbiosis and inflammation.

Objective:

The purpose of this study was to examine associations between feeding tube dwell time and GIT pro-inflammatory cytokine response.

Design/Methods:

We conducted a randomized clinical trial where VLBW infants were randomized into 2 groups within the first 72 hours of life. The intervention group had feeding tubes changed every 0-48 hours, and the standard of care group had feeding tubes changed every 7 days. Gastric samples were obtained via feeding tube aspiration and stool samples were collected from the infant’s diaper weekly for the first 4 weeks of life. Samples were analyzed using S100A12 and calprotectin immunoassays. We conducted bivariate analyses to examine the associations between feeding tube dwell time and GIT pro-inflammatory responses.

Results: A total of 133 VLBW infants were included in the analysis. Demographic information is presented in Table 1. Gastric S100A12 at 4 weeks of life was significantly lower in infants who had feeding tubes changed every 0-48 hours (Mean rank = 20.35) in comparison to infants who had feeding tubes changed every 7 days (Mean rank = 30.64), (U = 425.00, p= 0.014). There was no significant difference in gastric S100A12 for the first 3 weeks of life or fecal S100A12 or calprotectin for the first 4 weeks of life between groups (Table 2).

Conclusion(s): Inflammatory responses in gastric samples from infants who had their feeding tube changed every 0-48 hours decreased but only S100A12 at 4 weeks was statistically significant different. Because gastric samples were collected near the distal tip of the feeding tube, inflammatory responses could be different than those found in fecal samples. S100A12 is more often associated with microbiome composition and more sensitive and specific than calprotectin which may explain why we found a significant difference in gastric S100A12, but not calprotectin. We are currently analyzing the gastric and fecal microbiomes via 16S rRNA sequencing and metagenomics for dysbiosis and feeding tubes will be cultured to examine colonization patterns and associations with proinflammatory responses.