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Book Details
Abstract
Dr. Richard Polin’s Neonatology Questions and Controversies series highlights the most challenging aspects of neonatal care, offering trustworthy guidance on up-to-date diagnostic and treatment options in the field. In each volume, renowned experts address the clinical problems of greatest concern to today’s practitioners, helping you handle difficult practice issues and provide optimal, evidence-based care to every patient.
- Stay fully up to date in this fast-changing field with Gastroenterology and Nutrition, 3rd Edition.
- Emerging knowledge about the basic developmental physiology of upper intestinal motility as it relates to reflux and feeding tolerance, and immaturities in motility by altering composition of feedings and pharmacologic means.
- New content on genetics and pharmacology, the role of inflammation in systemic diseases in other organs as well as necrotizing enterocolitis, optimizing administration of lipids to preterm infants, and administering lipids to infants who are at high risk for complications secondary to suboptimal lipid therapies.
- Current coverage of the composition of human milk and clinical trials that address the efficacy of donor milk in comparison to formula and own mother’s milk.
- Consistent chapter organization to help you find information quickly and easily.
- The most authoritative advice available from world-class neonatologists who share their knowledge of new trends and developments in neonatal care.
Purchase each volume individually, or get the entire 7-volume set! Gastroenterology and Nutrition Hematology, Immunology and Genetics Hemodynamics and Cardiology Infectious Disease and Pharmacology New Volume! Nephrology and Fluid/Electrolyte Physiology Neurology The Newborn Lung
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IFC | ES1 | ||
| Neonatology Questions and Controversies | i | ||
| Series Page | ii | ||
| Neonatology Questions and Controversies | iii | ||
| Copyright | iv | ||
| Contributors | v | ||
| Series Foreword | ix | ||
| Preface | x | ||
| Contents | xii | ||
| Neonatology Questions and Controversies | xiv | ||
| 1 - Maturation of Motor Function in the Preterm Infant and Gastroesophageal Reflux | 1 | ||
| Upper Gastrointestinal Motility and Physiology | 1 | ||
| Diagnosis of Gastroesophageal Reflux and Gastroesophageal Reflux Disease | 2 | ||
| Physiologic Gastroesophageal Reflux | 2 | ||
| Gastroesophageal Reflux Disease—Symptoms | 3 | ||
| Gastroesophageal Reflux Disease—Diagnostic Tests | 4 | ||
| Gastroesophageal Reflux Disease—Treatment | 5 | ||
| Nonpharmacologic Measures | 5 | ||
| Pharmacologic Therapy | 6 | ||
| Acid-Blocking Medications | 8 | ||
| Prokinetics | 9 | ||
| Summary | 10 | ||
| REFERENCES | 11 | ||
| 2 - Development of Gastrointestinal Motility Reflexes | 15 | ||
| Introduction | 15 | ||
| Embryologic Aspects of Motility Development | 15 | ||
| Pharyngo-esophageal Motility Reflexes in Human Neonates | 17 | ||
| Maturation of Esophageal Peristalsis and Upper Esophageal Sphincter and Lower Esophageal Sphincter Functions | 17 | ||
| Maturation of Basal and Adaptive Esophageal Motility | 17 | ||
| Gastrointestinal Motility Reflexes in Human Neonates | 20 | ||
| Gastric Motor Functions | 20 | ||
| Small Intestine Motor Functions | 21 | ||
| Development of Colonic Motility in Human Neonates | 23 | ||
| Summary | 24 | ||
| Implications and Controversies of Gut Motility in Neonatal Gastrointestinal Therapies | 24 | ||
| REFERENCES | 25 | ||
| 3 - Lipid and Fatty Acid Delivery in the Preterm Infant: Challenges and Lessons Learned from Other Critically Ill Populations | 29 | ||
| Introduction | 29 | ||
| Lipids and Fatty Acids Maintaining Function and Health | 29 | ||
| Mechanisms and Significance of Fatty Acid Alterations in Cystic Fibrosis | 30 | ||
| Defects in Fatty Acid Metabolism | 30 | ||
| Pancreatic Insufficiency and Lipid Maldigestion | 31 | ||
| Defects in Intestinal Absorption | 31 | ||
| Role of Ileal Brake in Feeding Tolerance | 32 | ||
| Lipid and Fatty Acids in Preterm Infants | 32 | ||
| Parenteral Nutrition | 32 | ||
| Enteral Nutrition | 33 | ||
| Developmental Exocrine Pancreatic Insufficiency | 33 | ||
| Fat Maldigestion and Specific Fatty Acid Absorption Coefficients | 34 | ||
| Bioavailability of Other Lipid Classes | 34 | ||
| Ileal Brake and Feeding Intolerance | 35 | ||
| Strategies to Improve Lipid and Fatty Acid Delivery, Digestion, and Absorption | 36 | ||
| Enzyme-Based Therapies | 36 | ||
| Supplementation | 37 | ||
| Structured Lipids | 37 | ||
| Milk Fat Globule Membrane Fragments | 38 | ||
| Other Strategies | 38 | ||
| Summary | 38 | ||
| REFERENCES | 39 | ||
| 4 - Human Milk Oligosaccharide | 43 | ||
| Introduction | 43 | ||
| Structure and Composition | 44 | ||
| Digestion and Absorption | 47 | ||
| Functions | 47 | ||
| Prebiotic Functions | 47 | ||
| Antiinfective Functions | 48 | ||
| Immune Regulation | 49 | ||
| Somatic Growth | 50 | ||
| Reduced Severity of Necrotizing Enterocolitis | 51 | ||
| Intestinal Adaptation | 52 | ||
| Neurodevelopment | 53 | ||
| Randomized Controlled Trials in Healthy, Term Infants | 54 | ||
| Summary | 55 | ||
| REFERENCES | 55 | ||
| 5 - Donor Milk Trials | 59 | ||
| Introduction | 59 | ||
| History of Donor Milk | 60 | ||
| Current State of Milk Banking | 66 | ||
| Nutrient and Bioactive Composition of Donor Milk | 66 | ||
| Strengths and Challenges of Conducting and Comparing Donor Milk Trials | 68 | ||
| Outcomes of Randomized Controlled Clinical Trials of Donor Milk | 69 | ||
| Growth | 69 | ||
| Early Growth | 69 | ||
| Late Growth | 73 | ||
| Metabolic Responses | 73 | ||
| Necrotizing Enterocolitis and Late-Onset Sepsis | 74 | ||
| Neurodevelopment | 76 | ||
| Retinopathy of Prematurity | 78 | ||
| Mortality | 78 | ||
| Nonrandomized Studies of Donor Milk | 79 | ||
| Ongoing Trials | 80 | ||
| Conclusions | 81 | ||
| REFERENCES | 82 | ||
| 6 - Neonatal Necrotizing Enterocolitis: Neonatology Questions and Controversies | 87 | ||
| Introduction | 87 | ||
| NEC—Back to Basics | 87 | ||
| Microbiome | 88 | ||
| Antibiotics | 91 | ||
| Antireflux Medications | 91 | ||
| Blood Transfusions | 92 | ||
| Feedings | 93 | ||
| Probiotics | 94 | ||
| Conclusion | 95 | ||
| REFERENCES | 96 | ||
| 7 - Nutrition for the Surgical Neonate | 99 | ||
| Introduction | 99 | ||
| Growth in Surgical Neonates | 99 | ||
| Surgical Stress Response to Operative Trauma and Critical Illness | 100 | ||
| Energy Requirements During Stress | 100 | ||
| Macronutrient Metabolism and Requirements During Stress | 101 | ||
| Micronutrient Metabolism and Requirements | 103 | ||
| Fluid and Electrolyte Requirements | 104 | ||
| Routes of Nutrient Provision | 105 | ||
| Medications and Supplements | 106 | ||
| Special Disease Considerations | 106 | ||
| Necrotizing Enterocolitis | 106 | ||
| Abdominal Wall Defects | 107 | ||
| Intestinal Atresia | 107 | ||
| Short Gut Syndrome | 107 | ||
| Congenital Diaphragmatic Hernia | 107 | ||
| Extracorporeal Life Support | 108 | ||
| Summary | 108 | ||
| REFERENCES | 108 | ||
| 8 - Controversies in Short Bowel Syndrome | 113 | ||
| Controversy 1: Lipid Minimization versus Lipid Modification | 113 | ||
| Toxic Effects of Lipids | 114 | ||
| Clinical Approaches to Minimizing Lipid Toxicity | 114 | ||
| Controversy 2: Is Septicemia in Short Bowel Syndrome Caused by Bacterial Translocation or by Suboptimal Central Line Care? | 116 | ||
| Parenteral Nutrition and Epithelial Integrity | 116 | ||
| Microbial Ingress: Mechanisms and Clinical Evidence | 116 | ||
| Bacterial Profiling | 117 | ||
| Controversy 3: What Is Wrong with the Intestinal Microbiota in Short Bowel Syndrome? | 117 | ||
| Abnormal Microbial Colonization | 117 | ||
| Metabolic Impact of the Altered Microbiota in Short Bowel Syndrome | 118 | ||
| Controversy 4: Should Small Bowel Bacterial Overgrowth Prophylaxis Be Given? | 119 | ||
| Controversy 5: What Is the Optimal Way to Feed? | 120 | ||
| Controversy 6: What to Monitor and When? | 122 | ||
| Controversy 7: How Does One Predict Whether Full Intestinal Adaptation Will Occur? | 126 | ||
| Summary | 127 | ||
| REFERENCES | 127 | ||
| 9 - New Lipid Strategies to Prevent/Treat Neonatal Cholestasis | 133 | ||
| Introduction | 134 | ||
| Role of Intravenous Lipid Emulsions | 135 | ||
| Inflammatory Characteristics of Oil Source | 135 | ||
| Other Oil Sources | 137 | ||
| Role of Phytosterols in the Pathogenesis of IFALD | 138 | ||
| Other Plant Toxins | 139 | ||
| Alpha-Tocopherol | 140 | ||
| Impact of Lipid Dose on Predisposing Patients to IFALD | 140 | ||
| Impact of Lipid Dispensing/Infusion Practices | 141 | ||
| Lipid Emulsion Strategies in the Treatment of IFALD | 142 | ||
| Soybean Oil–Based Lipid Emulsions | 142 | ||
| Fish Oil–Based Lipid Emulsions | 142 | ||
| Concerns about Fish Oil Monotherapy | 144 | ||
| Bleeding | 144 | ||
| Essential Fatty Acid Deficiency | 145 | ||
| Long-Term Use of Fish Oil Monotherapy | 146 | ||
| Failure to Respond to Fish Oil Monotherapy | 147 | ||
| Soy–Fish Oil Blends | 148 | ||
| Alternative Lipid Emulsions | 148 | ||
| Role of Lipid Emulsions in the Prevention of IFALD | 149 | ||
| Soybean Oil | 149 | ||
| Fish Oil | 150 | ||
| Conclusion | 150 | ||
| REFERENCES | 151 | ||
| 10 - Neonatal Gastrointestinal Tract as a Conduit to Systemic Inflammation | 157 | ||
| Overview | 157 | ||
| Components and Functions of the Gastrointestinal Epithelium | 157 | ||
| Microbiome and Diversity | 160 | ||
| Special Neonatal Challenges | 160 | ||
| Total Parenteral Nutrition | 163 | ||
| Antibiotic Use and the Microbiome | 163 | ||
| Gastrointestinal Impact on Systemic Inflammation | 164 | ||
| Developmental Sequelae of Inflammation | 166 | ||
| Preventive Measures | 167 | ||
| Summary | 167 | ||
| REFERENCES | 168 | ||
| 11 - Adult Consequences of Neonatal and Fetal Nutrition: Mechanisms | 173 | ||
| Early Nutrition and Adult Phenotype | 173 | ||
| Developmental Biology of the Adult Consequences of Neonatal and Fetal Nutrition | 176 | ||
| Fetus/Intrauterine Growth Restriction | 176 | ||
| Metabolism | 177 | ||
| Leptin | 177 | ||
| Adiponectin | 178 | ||
| Insulin-Like Growth Factor-1 | 179 | ||
| Cardiovascular | 184 | ||
| Renal Morphogenesis | 184 | ||
| Endothelial Dysfunction | 185 | ||
| Neuroendocrine Reprogramming | 187 | ||
| Postnatal Nutrition, Particularly with the Preterm Infant, and Possible Interventions | 189 | ||
| Conclusion | 190 | ||
| REFERENCES | 190 | ||
| 12 - What Are the Controversies, and Where Will the Field be Moving in the Future? | 195 | ||
| Index | 197 | ||
| A | 197 | ||
| B | 197 | ||
| C | 198 | ||
| D | 198 | ||
| E | 198 | ||
| F | 199 | ||
| G | 199 | ||
| H | 200 | ||
| I | 200 | ||
| L | 201 | ||
| M | 201 | ||
| N | 202 | ||
| O | 202 | ||
| P | 203 | ||
| R | 203 | ||
| S | 203 | ||
| T | 204 | ||
| U | 204 | ||
| V | 204 | ||
| W | 204 | ||
| Z | 204 | ||
| IBC | ES2 |