Abstract 15650: Nutritional Support With Medium Chain Fatty Acids During Extracorporeal Membrane Oxygenation in Infant Swine Model
Bibliographic record
Abstract
Background: Extracorporeal membrane oxygenation (ECMO) is the most frequently used mechanical circulatory support in children with cardiopulmonary failure. Nutritional energy support as well as inotropic support is important to recover cardiac function during ECMO. Fatty acids (FAs) are major myocardial energy source for citric acid cycle (CAC). Medium-chain FAs (MCFAs) are easily uptaken into cell and mitochondria without membrane transporters. Our previous animal study suggested that MCFAs can potentially use for myocardial energy metabolism as the best accessible substrates during ECMO. Even-numbered MCFAs enter into CAC via acetyl-CoA, while odd-numbered MCFAs are anaplerotic for the CAC as propionyl-CoA in addition to acetyl-CoA. This study assessed whether odd- or even-numbered MCFAs product efficient energy during a short-term ECMO. Methods: Fifteen male Yorkshire pigs (26-45 days old) with 8-hour ECMO were received either normal saline, heptanoate (odd-numbered MCFA) or octanoate (even-numbered MCFA) at 2.3 μmol/kg body wt/min as MCFAs systemically during ECMO (n = 5 per group). The 13-Carbon ( 13 C) labeled substrates ([2- 13 C]lactate, [5,6,7- 13 C 3 ]heptanoate and [U- 13 C 6 ]leucine) as metabolic markers were infused into coronary artery for the final hour before left ventricular tissue extraction. Extracted left ventricular tissues were analyzed for the 13 C-labeled and absolute concentrations of metabolites by nuclear magnetic resonance and gas chromatography-mass spectrometry. Results: There were no adverse events in any groups during experiments. Octanoate produced markedly high citrate concentration, indicating the conjugation of CAC, and led to high [ATP]/[ADP] ratio compared with other groups (6.2 ± 0.6, 6.0 ± 0.6 and 7.8 ± 0.5 in normal saline, heptanoate and octanoate, P < 0.05). Octanoate strongly increased the CAC metabolism through anaplerotic pathway from propionyl-CoA, but not heptanoate. Lactate oxidation and protein synthesis ratio from leucine were not different among 3 groups. Conclusions: Even-numbered MCFAs was superior energy source for CAC than odd-numbered MCFAs in normal heart supported with ECMO. These results support that nutritional therapy with even-numbered MCFAs facilitates weaning from ECMO.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".