Abstract
At present no data are available on the effects of unconjugated bilirubin (UCB) on the gut of the preterm. We evaluated 25 jaundiced preterm (12 male, GA 35.0±1.0 wks, BW 2152.2±301.3 g, serum bilirubin201.7millimol/L (range 97.4 - 265). Gastric electrical activity was recorded by cutaneous electrogastrography (EGG module UPS 2020 - MMS) for 30 minutes before and one hour after formula feed and the following parameters evaluated: gastric frequency and power, instability coefficient of frequency and power, percentage of normal slow wave, bradygastria and tachygastria. The urinary lactulose/mannitol ratio (La/Ma ratio) was measured after oral ingestion of a solution containing 8.6 g of lactulose and 140 mg of mannitol per 100 ml water at a dose of 2 ml/kg. Urine was then collected for five hours; lactulose and mannitol concentrations were measured by HPLC (high liquid phase chromatography) (mg/l) and La/Ma ratio calculated. Fecal calprotectin (FC) was measured by an ELISA kit (Calprest) and the stool samples were treated following the manufacturer s instructions. In the preprandial period, serum bilirubin correlates positively with the percentage of normal slow waves (r=0.60; p< 0.001) and negatively with percentage of tachygastria (r-0.42; p< 0.03). Correlations were lost in the postprandial period. A multiple linear regression model showed that intestinal permeability (La/Ma ratio) (mean 0.25 ± 0.15) is influenced by both UCB and FC (mean 319.8± 4.5) (r=051; p=0.03). These data show that UCB affects IP, gastric motility and gut inflammation. We believe that UCB represents a condition of increased risk for preterms due to a complex involvment of the whole intestinal apparatus that has never been hypothesised before.
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Baldassarre, M., Indrio, F., Francavilla, R. et al. 120 Effect of Unconjugated Bilirubin on Gastric Motility Intestinal Permeability (IP) and Fecal Calprotectin in Preterm Newborns. Pediatr Res 58, 375 (2005). https://doi.org/10.1203/00006450-200508000-00149
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DOI: https://doi.org/10.1203/00006450-200508000-00149
