A comparison of intragastric and intrajejunal feedings in neonatal piglets

Intrajejunal feedings by continuous infusion of nutrients into the proximal jejunum have been advocated for premature and low-birthweight infants. This technique eliminates the risks of gastric distention and aspiration associated with intragastric feedings. However, intrajejunal feedings disregard the normal physiologic responses to gastric feedings and completely bypass the stomach and duodenum, thus eliminating the important contributions to intestinal function of salivary enzymes, pancreatic secretions, and duodenal osmoregulation and absorption. The objective of this investigation is the comparison in neonatal piglets of differences in nutritional status and intestinal absorption between animals administered intrajejunal nutrients with those given intragastric formula. A total of 14 three- to five-day-old 1.5 to 2.5 kg domestic strain piglets were studied for two weeks. Seven animals underwent operative insertion of a jejunostomy tube into the proximal jejunum, while seven animals had a gastrostomy tube inserted. Intravenous antibiotics and fluids were given for two days postoperatively, then Premature Enfamil (24 kcal/oz) was administered continuously through the feeding tube. The animals were maintained on 115 kcal/kg/d for 10 to 14 days with daily measurements of weight, height, length, stool volume, and weekly determinations of electrolytes, blood counts, and fecal fat analysis. Student's unpaired t-test analysis of the data reveals significantly greater weight gain in the gastrostomy animals (2.5% weight gain/d +/- 0.3% v 1.5% +/- 0.3%, P less than 0.05). These animals also had less diarrhea (14% v 71%), and less fat malabsorption (0.15g/48 hr v 0.9g/48 hr).(ABSTRACT TRUNCATED AT 250 WORDS)