Role of early enteral feeding and acute starvation on postburn bacterial translocation and host defense

Prospective, randomized trials

L. Gianotti, J. W. Alexander, J. L. Nelson, R. Fukushima, Tonyia Eaves-Pyles, C. L. Chalk

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

Objectives: To investigate the effect of: a) starvation during the preburn period and b) immediate postburn enteral nutrition on the permeability of the gut to microorganisms and the ability of the host to kill translocated bacteria. Design: Prospective, randomized, experimental trials. Setting: Laboratory. Subjects: Balb/c mice and Hartley guinea pigs. Interventions: In the first experiment, mice were starved for 0, 6, 12, 18, or 24 hrs before receiving gavage with 1010 14C-labeled Escherichia coli and a 20% burn injury. In the second experiment, guinea pigs received a 40% burn injury and were randomized to receive a complete enteral diet (175 kcal/kg/day) or infusion of an equal volume of lactated Ringer's solution via a previously placed gastrostomy for 6, 24, or 48 hrs. After each feeding period, 1010 14C Escherichia coli were infused intragastrically. In both experiments, the animals were killed 4 hrs after gavage, and mesenteric lymph nodes, spleen, liver, lungs, peritoneal fluid, and blood were harvested aseptically. Measurements: For each tissue or fluid, the number of viable E. coli and radionuclide counts of the 14C E. coli were measured and the percentage of translocated bacteria that remained alive was calculated. Main Results: In mice, 18 and 24 hrs of preburn starvation increased translocation only to the mesenteric lymph nodes, but it also enhanced bacterial killing in all tested tissues. Guinea pigs that were fed enterally for 6, 24, and 48 hrs postburn had significantly lower bacterial translocation in all tissues compared with animals infused with lactated Ringer's solution. Additionally, enhanced killing of translocating organisms was observed after 24 and 48 hrs of feeding. Conclusions: Starvation preburn has different consequences than starvation postburn on translocation and bacterial killing. Postburn enteral nutrition decreases the load of viable bacteria in the tissues via a double mechanism: an initial decreased translocation and a subsequent improved ability to kill bacteria that do translocate.

Original languageEnglish (US)
Pages (from-to)265-272
Number of pages8
JournalCritical Care Medicine
Volume22
Issue number2
StatePublished - 1994
Externally publishedYes

Fingerprint

Bacterial Translocation
Enteral Nutrition
Starvation
Escherichia coli
Bacteria
Guinea Pigs
Lymph Nodes
Gastrostomy
Ascitic Fluid
Wounds and Injuries
Radioisotopes
Small Intestine
Permeability
Spleen
Diet
Lung
Liver
Ringer's solution
Ringer's lactate

Keywords

  • bacterial infection
  • bacterial translocation
  • burn injury
  • critical illness
  • enteral nutrition
  • Escherichia coli
  • host defense
  • infection
  • intestinal function
  • intestinal mucosa
  • nutrition
  • sepsis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Role of early enteral feeding and acute starvation on postburn bacterial translocation and host defense : Prospective, randomized trials. / Gianotti, L.; Alexander, J. W.; Nelson, J. L.; Fukushima, R.; Eaves-Pyles, Tonyia; Chalk, C. L.

In: Critical Care Medicine, Vol. 22, No. 2, 1994, p. 265-272.

Research output: Contribution to journalArticle

Gianotti, L. ; Alexander, J. W. ; Nelson, J. L. ; Fukushima, R. ; Eaves-Pyles, Tonyia ; Chalk, C. L. / Role of early enteral feeding and acute starvation on postburn bacterial translocation and host defense : Prospective, randomized trials. In: Critical Care Medicine. 1994 ; Vol. 22, No. 2. pp. 265-272.
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abstract = "Objectives: To investigate the effect of: a) starvation during the preburn period and b) immediate postburn enteral nutrition on the permeability of the gut to microorganisms and the ability of the host to kill translocated bacteria. Design: Prospective, randomized, experimental trials. Setting: Laboratory. Subjects: Balb/c mice and Hartley guinea pigs. Interventions: In the first experiment, mice were starved for 0, 6, 12, 18, or 24 hrs before receiving gavage with 1010 14C-labeled Escherichia coli and a 20{\%} burn injury. In the second experiment, guinea pigs received a 40{\%} burn injury and were randomized to receive a complete enteral diet (175 kcal/kg/day) or infusion of an equal volume of lactated Ringer's solution via a previously placed gastrostomy for 6, 24, or 48 hrs. After each feeding period, 1010 14C Escherichia coli were infused intragastrically. In both experiments, the animals were killed 4 hrs after gavage, and mesenteric lymph nodes, spleen, liver, lungs, peritoneal fluid, and blood were harvested aseptically. Measurements: For each tissue or fluid, the number of viable E. coli and radionuclide counts of the 14C E. coli were measured and the percentage of translocated bacteria that remained alive was calculated. Main Results: In mice, 18 and 24 hrs of preburn starvation increased translocation only to the mesenteric lymph nodes, but it also enhanced bacterial killing in all tested tissues. Guinea pigs that were fed enterally for 6, 24, and 48 hrs postburn had significantly lower bacterial translocation in all tissues compared with animals infused with lactated Ringer's solution. Additionally, enhanced killing of translocating organisms was observed after 24 and 48 hrs of feeding. Conclusions: Starvation preburn has different consequences than starvation postburn on translocation and bacterial killing. Postburn enteral nutrition decreases the load of viable bacteria in the tissues via a double mechanism: an initial decreased translocation and a subsequent improved ability to kill bacteria that do translocate.",
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AU - Fukushima, R.

AU - Eaves-Pyles, Tonyia

AU - Chalk, C. L.

PY - 1994

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N2 - Objectives: To investigate the effect of: a) starvation during the preburn period and b) immediate postburn enteral nutrition on the permeability of the gut to microorganisms and the ability of the host to kill translocated bacteria. Design: Prospective, randomized, experimental trials. Setting: Laboratory. Subjects: Balb/c mice and Hartley guinea pigs. Interventions: In the first experiment, mice were starved for 0, 6, 12, 18, or 24 hrs before receiving gavage with 1010 14C-labeled Escherichia coli and a 20% burn injury. In the second experiment, guinea pigs received a 40% burn injury and were randomized to receive a complete enteral diet (175 kcal/kg/day) or infusion of an equal volume of lactated Ringer's solution via a previously placed gastrostomy for 6, 24, or 48 hrs. After each feeding period, 1010 14C Escherichia coli were infused intragastrically. In both experiments, the animals were killed 4 hrs after gavage, and mesenteric lymph nodes, spleen, liver, lungs, peritoneal fluid, and blood were harvested aseptically. Measurements: For each tissue or fluid, the number of viable E. coli and radionuclide counts of the 14C E. coli were measured and the percentage of translocated bacteria that remained alive was calculated. Main Results: In mice, 18 and 24 hrs of preburn starvation increased translocation only to the mesenteric lymph nodes, but it also enhanced bacterial killing in all tested tissues. Guinea pigs that were fed enterally for 6, 24, and 48 hrs postburn had significantly lower bacterial translocation in all tissues compared with animals infused with lactated Ringer's solution. Additionally, enhanced killing of translocating organisms was observed after 24 and 48 hrs of feeding. Conclusions: Starvation preburn has different consequences than starvation postburn on translocation and bacterial killing. Postburn enteral nutrition decreases the load of viable bacteria in the tissues via a double mechanism: an initial decreased translocation and a subsequent improved ability to kill bacteria that do translocate.

AB - Objectives: To investigate the effect of: a) starvation during the preburn period and b) immediate postburn enteral nutrition on the permeability of the gut to microorganisms and the ability of the host to kill translocated bacteria. Design: Prospective, randomized, experimental trials. Setting: Laboratory. Subjects: Balb/c mice and Hartley guinea pigs. Interventions: In the first experiment, mice were starved for 0, 6, 12, 18, or 24 hrs before receiving gavage with 1010 14C-labeled Escherichia coli and a 20% burn injury. In the second experiment, guinea pigs received a 40% burn injury and were randomized to receive a complete enteral diet (175 kcal/kg/day) or infusion of an equal volume of lactated Ringer's solution via a previously placed gastrostomy for 6, 24, or 48 hrs. After each feeding period, 1010 14C Escherichia coli were infused intragastrically. In both experiments, the animals were killed 4 hrs after gavage, and mesenteric lymph nodes, spleen, liver, lungs, peritoneal fluid, and blood were harvested aseptically. Measurements: For each tissue or fluid, the number of viable E. coli and radionuclide counts of the 14C E. coli were measured and the percentage of translocated bacteria that remained alive was calculated. Main Results: In mice, 18 and 24 hrs of preburn starvation increased translocation only to the mesenteric lymph nodes, but it also enhanced bacterial killing in all tested tissues. Guinea pigs that were fed enterally for 6, 24, and 48 hrs postburn had significantly lower bacterial translocation in all tissues compared with animals infused with lactated Ringer's solution. Additionally, enhanced killing of translocating organisms was observed after 24 and 48 hrs of feeding. Conclusions: Starvation preburn has different consequences than starvation postburn on translocation and bacterial killing. Postburn enteral nutrition decreases the load of viable bacteria in the tissues via a double mechanism: an initial decreased translocation and a subsequent improved ability to kill bacteria that do translocate.

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KW - critical illness

KW - enteral nutrition

KW - Escherichia coli

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KW - intestinal function

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KW - nutrition

KW - sepsis

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