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Digestive enzyme replacement relieves growth failure in preterm infants with poor exocrine pancreatic function: a retrospective case series
In orally fed preterm infants, poor weight gain may be linked to low fecal pancreatic elastase-1 (FPE-1) activity, indicative of exocrine pancreatic insufficiency. The objective of this study was the retrospective assessment of the effect of exogenous digestive enzyme replacement by gavage in preter...
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| Published in: | European journal of pediatrics 2021-09, Vol.180 (9), p.2951-2958 |
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| container_title | European journal of pediatrics |
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| creator | Münch, Annette Bührer, Christoph Longardt, Ann Carolin |
| description | In orally fed preterm infants, poor weight gain may be linked to low fecal pancreatic elastase-1 (FPE-1) activity, indicative of exocrine pancreatic insufficiency. The objective of this study was the retrospective assessment of the effect of exogenous digestive enzyme replacement by gavage in preterm infants with growth failure and low FPE-1 ( |
| doi_str_mv | 10.1007/s00431-021-04069-0 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8346403</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2511901287</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-956c72c3fa3a6adbef7bf124ceb23e6a31883ea389e77b05f6a8f4f1bc51ccbe3</originalsourceid><addsrcrecordid>eNp9kctu1TAQhi0EoqeFF2CBLLFhE_AticMCCRUKSJXYwNqauONTV4kdbOeU8gq8NG5PKZcFC8sjzTf_XH5CnnD2gjPWv8yMKckbJupTrBsado9suJKi4azv7pMNk4o1HR-GA3KY8wWrRQPXD8mBlFoOAxcb8uOt32IufocUw_erGWnCZQKLM4ZS48njDjPdpnhZzqkDP60JqQ90SVgwzTV0EEqml77mlxgTxW_RJh-QLhBsQijeUrcGW3wMryhU0ZJiXtDedLWQkWZMHvMj8sDBlPHx7X9Evpy8-3z8oTn99P7j8ZvTxqpelWZoO9sLKx1I6OBsRNePjgtlcRQSO5Bca4kg9YB9P7LWdaCdcny0Lbd2RHlEXu91l3Wc8czWTRNMZkl-hnRlInjzdyb4c7ONO6Ol6hSTVeD5rUCKX9d6PjP7bHGaIGBcsxEt5wPjQvcVffYPehHXFOp6lWq1bgWXrFJiT9l6mZzQ3Q3Dmbn22uy9NtVrc-O1uS56-ucadyW_zK2A3AO5psIW0-_e_5H9CcXguho</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2558852130</pqid></control><display><type>article</type><title>Digestive enzyme replacement relieves growth failure in preterm infants with poor exocrine pancreatic function: a retrospective case series</title><source>Springer Nature</source><creator>Münch, Annette ; Bührer, Christoph ; Longardt, Ann Carolin</creator><creatorcontrib>Münch, Annette ; Bührer, Christoph ; Longardt, Ann Carolin</creatorcontrib><description>In orally fed preterm infants, poor weight gain may be linked to low fecal pancreatic elastase-1 (FPE-1) activity, indicative of exocrine pancreatic insufficiency. The objective of this study was the retrospective assessment of the effect of exogenous digestive enzyme replacement by gavage in preterm infants with growth failure and low FPE-1 (<200 μg/g). We analyzed weight gain relative to baseline and caloric intake during 14-day periods before and after institution of digestive enzyme replacement containing 6000 U lipase and 240 U protease kg
−1
d
−1
. Among 46 of 132 preterm infants < 1250g birth weight surviving to at least 14 days in whom FPE-1 was determined, 38 infants had low FPE-1 (< 200 μg/g), and 33 infants received exogenous digestive enzyme replacement. Average daily weight gain significantly increased from 14.4 [range 2.6–22.4] g kg
−1
d
−1
to 17.4 [8.4–29.0] g kg
−1
d
−1
(
P
= 0.001), as did weight gain per kcal, from 0.08 [0.02–0.13] g kcal
−1
d
−1
to 0.11 [0.05–0.18] g kcal
−1
d
−1
.
Conclusion
: In preterm infants with signs and symptoms of exocrine pancreatic insufficiency, exogenous digestive enzyme replacement is associated with improved growth.
What is Known:
• Very preterm infants on full enteral nutrition may display growth failure linked to transient poor exocrine pancreatic function.
• Porcine pancreatic enzymes covered with an acid-resistant coating are too large to pass the internal diameter of most gavage tubes used in very preterm infants.
What is New:
• Administration of a liquid formulation of acid-resistant microbial digestive enzymes in preterm infants with growth failure and low fecal pancreatic elastase-1 values was associated with improved weight gain.
• Response to exogenous digestive enzyme replacement was associated with the prior extent of growth failure.</description><identifier>ISSN: 0340-6199</identifier><identifier>EISSN: 1432-1076</identifier><identifier>DOI: 10.1007/s00431-021-04069-0</identifier><identifier>PMID: 33839912</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Birth weight ; Digestive enzymes ; Elastase ; Enzymes ; Infants ; Medicine ; Medicine & Public Health ; Neonates ; Newborn babies ; Original ; Original Article ; Pancreas ; Pancreatic elastase ; Pediatrics ; Physical growth ; Premature babies</subject><ispartof>European journal of pediatrics, 2021-09, Vol.180 (9), p.2951-2958</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-956c72c3fa3a6adbef7bf124ceb23e6a31883ea389e77b05f6a8f4f1bc51ccbe3</citedby><cites>FETCH-LOGICAL-c474t-956c72c3fa3a6adbef7bf124ceb23e6a31883ea389e77b05f6a8f4f1bc51ccbe3</cites><orcidid>0000-0002-9950-414X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33839912$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Münch, Annette</creatorcontrib><creatorcontrib>Bührer, Christoph</creatorcontrib><creatorcontrib>Longardt, Ann Carolin</creatorcontrib><title>Digestive enzyme replacement relieves growth failure in preterm infants with poor exocrine pancreatic function: a retrospective case series</title><title>European journal of pediatrics</title><addtitle>Eur J Pediatr</addtitle><addtitle>Eur J Pediatr</addtitle><description>In orally fed preterm infants, poor weight gain may be linked to low fecal pancreatic elastase-1 (FPE-1) activity, indicative of exocrine pancreatic insufficiency. The objective of this study was the retrospective assessment of the effect of exogenous digestive enzyme replacement by gavage in preterm infants with growth failure and low FPE-1 (<200 μg/g). We analyzed weight gain relative to baseline and caloric intake during 14-day periods before and after institution of digestive enzyme replacement containing 6000 U lipase and 240 U protease kg
−1
d
−1
. Among 46 of 132 preterm infants < 1250g birth weight surviving to at least 14 days in whom FPE-1 was determined, 38 infants had low FPE-1 (< 200 μg/g), and 33 infants received exogenous digestive enzyme replacement. Average daily weight gain significantly increased from 14.4 [range 2.6–22.4] g kg
−1
d
−1
to 17.4 [8.4–29.0] g kg
−1
d
−1
(
P
= 0.001), as did weight gain per kcal, from 0.08 [0.02–0.13] g kcal
−1
d
−1
to 0.11 [0.05–0.18] g kcal
−1
d
−1
.
Conclusion
: In preterm infants with signs and symptoms of exocrine pancreatic insufficiency, exogenous digestive enzyme replacement is associated with improved growth.
What is Known:
• Very preterm infants on full enteral nutrition may display growth failure linked to transient poor exocrine pancreatic function.
• Porcine pancreatic enzymes covered with an acid-resistant coating are too large to pass the internal diameter of most gavage tubes used in very preterm infants.
What is New:
• Administration of a liquid formulation of acid-resistant microbial digestive enzymes in preterm infants with growth failure and low fecal pancreatic elastase-1 values was associated with improved weight gain.
• Response to exogenous digestive enzyme replacement was associated with the prior extent of growth failure.</description><subject>Birth weight</subject><subject>Digestive enzymes</subject><subject>Elastase</subject><subject>Enzymes</subject><subject>Infants</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neonates</subject><subject>Newborn babies</subject><subject>Original</subject><subject>Original Article</subject><subject>Pancreas</subject><subject>Pancreatic elastase</subject><subject>Pediatrics</subject><subject>Physical growth</subject><subject>Premature babies</subject><issn>0340-6199</issn><issn>1432-1076</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kctu1TAQhi0EoqeFF2CBLLFhE_AticMCCRUKSJXYwNqauONTV4kdbOeU8gq8NG5PKZcFC8sjzTf_XH5CnnD2gjPWv8yMKckbJupTrBsado9suJKi4azv7pMNk4o1HR-GA3KY8wWrRQPXD8mBlFoOAxcb8uOt32IufocUw_erGWnCZQKLM4ZS48njDjPdpnhZzqkDP60JqQ90SVgwzTV0EEqml77mlxgTxW_RJh-QLhBsQijeUrcGW3wMryhU0ZJiXtDedLWQkWZMHvMj8sDBlPHx7X9Evpy8-3z8oTn99P7j8ZvTxqpelWZoO9sLKx1I6OBsRNePjgtlcRQSO5Bca4kg9YB9P7LWdaCdcny0Lbd2RHlEXu91l3Wc8czWTRNMZkl-hnRlInjzdyb4c7ONO6Ol6hSTVeD5rUCKX9d6PjP7bHGaIGBcsxEt5wPjQvcVffYPehHXFOp6lWq1bgWXrFJiT9l6mZzQ3Q3Dmbn22uy9NtVrc-O1uS56-ucadyW_zK2A3AO5psIW0-_e_5H9CcXguho</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Münch, Annette</creator><creator>Bührer, Christoph</creator><creator>Longardt, Ann Carolin</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9950-414X</orcidid></search><sort><creationdate>20210901</creationdate><title>Digestive enzyme replacement relieves growth failure in preterm infants with poor exocrine pancreatic function: a retrospective case series</title><author>Münch, Annette ; Bührer, Christoph ; Longardt, Ann Carolin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-956c72c3fa3a6adbef7bf124ceb23e6a31883ea389e77b05f6a8f4f1bc51ccbe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Birth weight</topic><topic>Digestive enzymes</topic><topic>Elastase</topic><topic>Enzymes</topic><topic>Infants</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neonates</topic><topic>Newborn babies</topic><topic>Original</topic><topic>Original Article</topic><topic>Pancreas</topic><topic>Pancreatic elastase</topic><topic>Pediatrics</topic><topic>Physical growth</topic><topic>Premature babies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Münch, Annette</creatorcontrib><creatorcontrib>Bührer, Christoph</creatorcontrib><creatorcontrib>Longardt, Ann Carolin</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medicine (ProQuest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database (ProQuest)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Database (Proquest)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Münch, Annette</au><au>Bührer, Christoph</au><au>Longardt, Ann Carolin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Digestive enzyme replacement relieves growth failure in preterm infants with poor exocrine pancreatic function: a retrospective case series</atitle><jtitle>European journal of pediatrics</jtitle><stitle>Eur J Pediatr</stitle><addtitle>Eur J Pediatr</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>180</volume><issue>9</issue><spage>2951</spage><epage>2958</epage><pages>2951-2958</pages><issn>0340-6199</issn><eissn>1432-1076</eissn><abstract>In orally fed preterm infants, poor weight gain may be linked to low fecal pancreatic elastase-1 (FPE-1) activity, indicative of exocrine pancreatic insufficiency. The objective of this study was the retrospective assessment of the effect of exogenous digestive enzyme replacement by gavage in preterm infants with growth failure and low FPE-1 (<200 μg/g). We analyzed weight gain relative to baseline and caloric intake during 14-day periods before and after institution of digestive enzyme replacement containing 6000 U lipase and 240 U protease kg
−1
d
−1
. Among 46 of 132 preterm infants < 1250g birth weight surviving to at least 14 days in whom FPE-1 was determined, 38 infants had low FPE-1 (< 200 μg/g), and 33 infants received exogenous digestive enzyme replacement. Average daily weight gain significantly increased from 14.4 [range 2.6–22.4] g kg
−1
d
−1
to 17.4 [8.4–29.0] g kg
−1
d
−1
(
P
= 0.001), as did weight gain per kcal, from 0.08 [0.02–0.13] g kcal
−1
d
−1
to 0.11 [0.05–0.18] g kcal
−1
d
−1
.
Conclusion
: In preterm infants with signs and symptoms of exocrine pancreatic insufficiency, exogenous digestive enzyme replacement is associated with improved growth.
What is Known:
• Very preterm infants on full enteral nutrition may display growth failure linked to transient poor exocrine pancreatic function.
• Porcine pancreatic enzymes covered with an acid-resistant coating are too large to pass the internal diameter of most gavage tubes used in very preterm infants.
What is New:
• Administration of a liquid formulation of acid-resistant microbial digestive enzymes in preterm infants with growth failure and low fecal pancreatic elastase-1 values was associated with improved weight gain.
• Response to exogenous digestive enzyme replacement was associated with the prior extent of growth failure.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33839912</pmid><doi>10.1007/s00431-021-04069-0</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-9950-414X</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8346403 |
| source | Springer Nature |
| subjects | Birth weight Digestive enzymes Elastase Enzymes Infants Medicine Medicine & Public Health Neonates Newborn babies Original Original Article Pancreas Pancreatic elastase Pediatrics Physical growth Premature babies |
| title | Digestive enzyme replacement relieves growth failure in preterm infants with poor exocrine pancreatic function: a retrospective case series |
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