Use of Probiotics in the NICU

Use of Probiotics in the NICU ,[object Object]

[object Object],[object Object],Immunonutrition

Immunonutrition ,[object Object],Montgomery, RK (2008) Gastroenterology and Nutrition: Neonatology Questions and Controversies .

Immunonutrition ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Immunonutrition Bengt Björkst ė n, MD, PhD (2008) Probiotics: Facts, Fiction and Future NASPGHAN Body Surface Area Skin 2m 2 Lungs ~100 m 2 Airways 100m 2 Gut 300m 2 Lungs as Sheet Intestines as Sheet Skin as Box Parameter Number Seating Capacity of the OSU Stadium 102,329 Population of the United States (2011)* 311,077,408 World Population (2011)* 6,909,201,891 GDP of the United States (2010) 14,624,184,000,000 # of Mammalian Cells in your Body 10,000,000,000,000 # of Microbial Cells in/on your Body 100,000,000,000,000

Immunonutrition ,[object Object],Total Bacterial Counts (cfu/ml) stomach 0-10 3 jejunum 0-10 5 ileum 10 3 -10 7 colon 10 10 -10 13 1. Harmsen HJ, et al. J Pediatr Gastroenterol Nutr 2000;30:61–67 2. Guarner F, Malagelada JR. Lancet 2003;361:512–519 3. Orrhage K, Nord CE. Acta Paediatr Suppl 1999;88:47–57 Infant ~ 10 10 organisms (10,000,000,000) About 60% of fecal mass Over 400 species

Immunonutrition ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Immunonutrition ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Immunonutrition 0 10 20 30 40 50 60 70 g/L Lactose Fat Oligosaccharides Protein 1. Boehm G, Stahl B. J Nutr 2007;137 Suppl 2:847S–849S. 2. Coppa G, Bruni S, Morelli L, et al. J Clin Gastroenterol 2004;38 (2):S80-S83. 3. Chaturvedi P. Glycobiology 2001;11:5:365-372. 4. Erney R. J Pediatr Gastroenterol Nutr 2000;30:181-192. Oligosaccharides Large variety – well over 100 possible 3 >400 samples from women in 10 countries showed great variability 4 70 12 40 10 Third Largest Component of Human Milk 1,2

Immunonutrition ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Nestle Nutr Workshop Ser Pediatr Program. 2008;62:205-18; discussion 218-22

Immunonutrition ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Neu J & Bernstein, H Update on host defense and immunonutrients Clinics in Perinatology 29(1); 2002.

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[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Immunonutrition

Immunonutrition ,[object Object]

Immunonutrition ,[object Object],[object Object],[object Object],Tarnow-Mordi W et al Adjunctive immunologic interventions in neonatal sepsis. In Clinics in Perinatology 37(2) (2010) Hanson LA. Session 1: Feeding and infant development breastfeeding and immune function. Proc Nutr Soc 2007; 66(3): 384-96. ,[object Object],[object Object]

Immunonutrition ,[object Object],[object Object],Neu J & Bernstein, H Update on host defense and immunonutrients Clinics in Perinatology 29(1); 2002.

Immunonutrition ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Immunonutrition ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Probiotics Control P value Death, n% 7 (3.9) 10 (10.7) .009 Death or NEC cases, n (%) 9(5) 24(12.8) .009 NEC, stage 2 or 3, n(%) 2(1.1) 10(5.3) .04 Sepsis, n(%) 22(12.2) 36(19.3) .03 NEC or sepsis, n(%) 24(13.3) 46(24.6) .03 NEC, sepsis or death, n(%) 31(17.2) 60(32.1) .009

Immunonutrition ,[object Object],[object Object],[object Object],[object Object]

Immunonutrition ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Immunonutrition ,[object Object],[object Object],[object Object],[object Object],[object Object]

Use of Probiotics in the NICU

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