Transpyloric Feeding for Prevention of Micro-aspiration

Specific Aim 1): To determine the effect of TP feeding on microaspiration and lung
inflammation. Hypothesis: TP feeding will reduce the microaspiration and pulmonary
inflammation in ventilated preterm infants. Evaluate markers of microaspiration (pepsin A)
and lung inflammation [total cell counts, nuclear factor-kB (NF-kB) activation, tumor
necrosis factor-α (TNF-α), IL-1β, IL-6, IL-8, angiopoietin 2 (Ang2), high-mobility group
box-1 protein (HMGB1), macrophage migration inhibitory factor (MIF) and interferon-γ (IFN-γ)]
in TA samples obtained from preterm ventilated infants with and without TP feeding.

Specific Aim 2): To determine the effect of TP feeding on respiratory support. Hypothesis: TP
feeding will decrease the respiratory severity score (RSS) [Fraction of inspired oxygen
(FiO2) X mean airway pressure (MAP)] and number of infants requiring ventilator support.
Evaluate respiratory support in preterm ventilated infants with and without TP feeding.

Inclusion Criteria:

- Preterm infants with birth weight <1500 grams

- Requiring ventilatory support

Exclusion Criteria:

- Culture-proven sepsis

- Ventilator associated pneumonia (VAP).