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Endotoxemia Following Enteral Refeeding in Children

Toyokazu Yoshioka, MD

Masakatsu Goto, MD, PhD

Ronald M. Isaac, MD

Gilbert Goldman, MD

Department of Pediatrics, Loyola University Chicago

Rita I. Young, PhD

Department of Physiology, Loyola University of Chicago

W. Patrick Zeller, MD

Department of Pediatrics, Loyola University Chicago; Research Division, Hines VA Hospital.

Plasma endotoxin-like activity, tumor necrosis factor (TNF) concentrations, core body temperature, and liver functions were measured before and after enteral feeding in children who had been deprived of enteral feeding for 5 days because of their illness. Transient endotoxemia and elevations in plasma TNF concentrations occurred. Core body temperature, aspartate aminotransferase, alamine aminotransferase, and bilirubin concentrations were normal in patients who had elevated plasma endotoxin-like activity. Transient endotoxemia following enteral feeding may be due to the translocation from the gastrointestinal (GI) tract as a result of increased mesenteric circulation and peristalsis. No clinical consequences were noted despite transient endotoxemia. The transient endotoxemia is not due to the immature GI tract; instead, it results from enteral feeding following the deprivation of enteral feeds.

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