Fecal Elastase-1 Levels in Preterm Infants with Bronchopulmonary Dysplasia

Bronchopulmonary dysplasia (BPD), defined as the need for oxygen at 28 days of life, develops in preterm infants as a result of ventilatory strategies used to manage acute respiratory illness. The incidence rate of BPD is increasing as more and more extremely preterm infants survive acute respiratory illness. Inadequate growth is the most common morbidity affecting these infants, with attained weights well below the 10th percentile. One area in need of further research is the examination of the ability of the preterm infants with BPD to digest provided nutrients. The only study to date found that these infants have decreased pancreatic activity and increased fecal losses of nutrients, excreting 21.4% of fat intake and 13.5% of protein intake. This is an important finding given that the standard of care is to increase nutrients to promote growth. The purpose of this exploratory study was to examine pancreatic enzyme activity in preterm infants with BPD. Data were collected on preterm infants on full enteral nutrition at approximately 33 weeks post-conceptional age. Fecal elastase-1 levels (μg/gm of stool) were measured and compared to the expected normal value of 200 μg/gm of stool. Enzyme-linked immunosorbent assay (ELISA) was used to determine fecal elastase-1 levels. In our laboratory, the coefficient of variation for assays is less than 10%. To date, there has been very limited examination of the ability of preterm infants with BPD to digest the nutrients provided. The anticipated findings from this proposed project should provide a better understanding of digestion and provide the foundation for further study of gastrointestinal function in preterm infants with BPD.No embarg