Heat stress of gilts around farrowing causes oxygen insufficiency in the umbilical cord and reduces piglet survival.

Late gestating sows are susceptible to high ambient temperatures, possibly causing farrowing complications and reducing piglet survival. This experiment aimed to quantify in the days leading up to farrowing the impact of sow heat stress (HS) on farrowing physiology and survival of the piglets. Pregnant primiparous sows (gilts) were allocated to either thermoneutral control (CON, n = 8; constant 20 °C) or cyclical HS conditions (n = 8; 0900 h to 1700 h, 30 °C; 1700 h to 0900 h, 28 °C) from d 110 of gestation until farrowing completion. Gilt respiration rate, skin temperature and rectal temperature were recorded daily, and farrowing duration was quantified by video analyses. Blood samples were collected from the piglet umbilical vein at birth. At 48 h of age, piglet growth was quantified by morphometric analyses. The thermal exposure model induced HS and respiratory alkalosis in the gilts, as indicated by increased respiration rate, rectal temperature, skin temperature (all P < 0.001), plasma cortisol (P = 0.01) and blood pH (P < 0.001). Heat-stressed gilts took longer to start expelling placentae (P = 0.003), although the active farrowing duration was not significantly different between treatments. Stillbirth rates were higher in the HS group (P < 0.001), with surviving piglets at birth having lower umbilical vein partial pressure of oxygen (P = 0.04), oxygen saturation rate (P = 0.03) and tending to have increased lactate concentrations (P = 0.07). At birth, piglet skin meconium staining scores were greater in the HS group (P = 0.022). At 48 h of age, piglets from the HS group had reduced small intestinal length (P = 0.02), reduced jejunal crypt depth (P = 0.02) and lighter absolute brain weight (P = 0.001). In contrast, piglet BW, growth rate, relative organ weight and small intestinal mucosal barrier function did not change between treatments. Collectively, these findings demonstrated gilt HS during late gestation caused farrowing complications and reduced the umbilical oxygen supply to the piglets at parturition, leading to increased risks of piglet stillbirth with implications on impaired neonatal survivability and development.

Animal board invited review: Factors affecting the early growth and development of gilt progeny compared to sow progeny.

Progeny born to primiparous sows farrowing their first litter, often called gilt progeny (GP), are typically characterised by their poorer overall production performance than progeny from multiparous sows (sow progeny; SP). Gilt progeny consistently grow slower, are born and weaned lighter, and have higher postweaning illness and mortality rates than SP. Collectively, their poorer performance culminates in a long time to reach market weight and, ultimately, reduced revenue. Due to the high replacement rates of sows, the primiparous sow and her progeny represent a large proportion of the herd resulting in a significant loss for the pig industry. While the reasons for poorer performance are complex and multifaceted, they may largely be attributed to the immature age at which gilts are often mated and the significant impact of this on their metabolism during gestation and lactation. As a result, this can have negative consequences on the piglet itself. To improve GP performance, it is crucial to understand the biological basis for differences between GP and SP. The purpose of this review is to summarise published literature investigating differences in growth performance and health status between GP and SP. It also examines the primiparous sow during gestation and lactation and how the young sow must support her own growth while supporting the metabolic demands of her pregnancy and the growth and development of her litter. Finally, the underlying physiology of GP is discussed in terms of growth and development in utero, the neonatal period, and the early development of the gastrointestinal tract. The present review concludes that there are a number of interplaying factors relating to the anatomy and physiology of the primiparous sow and of GP themselves. The studies presented herein strongly suggest that poor support of piglet growth in utero and reduced colostrum and milk production and consumption are largely responsible for the underperformance of GP. It is therefore recommended that future management strategies focus on supporting the primiparous sow during gestation and lactation, increasing the preweaning growth of GP to improve their ability to cope with the stressors of weaning, selection of reproductive traits such as uterine capacity to improve birth weights and ultimately GP performance, and finally, increase the longevity of sows to reduce the proportion of GP entering the herd.

Review: What have we learned about the effects of heat stress on the pig industry?

Pig production faces seasonal fluctuations. The low farrowing rate of sows mated in summer, increased carcass fatness of progeny born to the sows mated in summer, and slower growth rate of finisher pigs in summer are three economically important impacts identified in the pig industry. The purpose of this review is to examine advances over the past decade in understanding the mechanisms underlying the three impacts associated with summer conditions, particularly heat stress (HS), and to provide possible amelioration strategies. For impact 1, summer mating results in low farrowing rates mainly caused by the high frequency of early pregnancy disruptions. The contributions of semen DNA damage, poor oocyte quality, local progesterone concentrations, and suboptimal embryonic oestrogen secretion are discussed, as these all may contribute to HS-mediated effects around conception. Despite this, it is still unclear what the underlying mechanisms might be and thus, there is currently a lack of commercially viable solutions. For impact 2, there have been recent advances in the understanding of gestational HS on both the sow and foetus, with gestational HS implicated in decreased foetal muscle fibre number, a greater proportion of lighter piglets, and increased carcass fatness at slaughter. So far, no effective strategies have been developed to mitigate the impacts associated with gestational HS on foetuses. For impact 3, the slowed growth rate of pigs during summer is one reason for the reduced carcass weights in summer. Studies have shown that the reduction in growth rates may be due to more than reductions in feed intake alone, and the impaired intestinal barrier function and inflammatory response may also play a role. In addition, it is consistently reported that HS attenuates fat mobilisation which can potentially exacerbate carcass fatness when carcass weight is increased. Novel feed additives have exhibited the potential to reduce the impacts of HS on intestinal barrier function in grower pigs. Collectively, based on these three impacts, the economic loss associated with HS can be estimated. A review of these impacts is warranted to better align the future research directions with the needs of the pig industry. Ultimately, a better understanding of the underlying mechanisms and continuous investments in developing commercially viable strategies to combat HS will benefit the pig industry.

Reduced growth performance in gilt progeny is not improved by segregation from sow progeny in the grower-finisher phase.

Gilt progeny (GP) are born and weaned lighter than sow progeny (SP) and tend to have higher rates of mortality and morbidity. This study quantified the lifetime growth performance differences between GP and SP and, additionally, evaluated whether segregating GP and SP in the grower-finisher period compared to mixing them within common pens reduced this variation. It was hypothesised that GP would be lighter than SP at every stage and segregation would improve growth performance of both GP and SP. All piglets born to 61 gilts (parity 1) and 47 sows (parities 2 to 7; mean 3.5 ± 0.2) were allocated to four treatments at 10 weeks of age: (i) GP housed together (GG), (ii) GP mixed (M) with SP (GM), (iii) SP housed together (SS) and (iv) SP mixed with GP (SM). The GM and SM pigs were housed together in common pens after movement into the grower-finisher facility. Individual live weight of all progeny was recorded at birth, weaning (WWT), 10 weeks of age (10WT) and sale (SWT). Individual hot carcass weight (HCW), fat depth at the head of the last rib (P2) and dressing percentage were measured at slaughter. Gilt progeny were lighter at birth (P = 0.038), weaning (P < 0.001) and through to sale (P = 0.001) than SP. Nursery and grower-finisher performance differences in GP were highly attributable to their lower WWT compared to SP (P < 0.001 when fitted as a covariate). Segregation of GP and SP increased grower-finisher average daily gain (ADG) in SP but decreased ADG and SWT in GP (P < 0.10). Segregated SP had increased average daily feed intake but only in males (P = 0.007); HCW (P < 0.001) and P2 fat depth (P = 0.055) were higher in mixed female GP, but there was no difference (P > 0.10) in female SP, or in males. In conclusion, GP were lighter at every stage than SP and differences after weaning were highly related to the lighter WWT of GP. Under the conditions of this study, overall segregation of GP and SP showed no consistent advantages in growth performance for both groups and differed significantly between males and females.

Filling the out of season gaps for lamb and hogget production: Diet and genetic influence on carcass yield, carcass composition and retail value of meat.

This study investigated the use of camelina forage and meal supplementation to a finishing diet on carcass traits, composition and retail value of lamb and hoggets. The metabolisable energy and crude protein concentrations of all 3 diets were 10-11 MJ/kg DM and 14-15% CP. Thirty maternal Composite wether lambs (28-38 kg) and 30 Merino wether hoggets (37-43 kg) were used in a 3 × 2 factorial experiment. Animals were slaughtered after 10 weeks of feeding with carcasses classified as 'Heavy lamb' or 'Heavy hogget' (>22 kg carcass weight). Carcass traits, composition, meat mineral concentrations and retail colour were measured. Camelina diets increased liveweight (P < 0.02) and carcass weight (P < 0.002) for both sheep types. Carcass weight (P < 0.005) and dressing % (P < 0.01) were lower for Merino hoggets than Composite lambs. Mineral concentration and retail colour stability of fresh meat were unaffected by diet, with 72 h retail colour considered acceptable for consumers.

Effects of a short-term supranutritional selenium supplementation on redox balance, physiology and insulin-related metabolism in heat-stressed pigs.

Heat stress (HS) disrupts redox balance and insulin-related metabolism. Supplementation with supranutritional amounts of selenium (Se) may enhance glutathione peroxidase (GPX) activity and reduce oxidative stress, but may trigger insulin resistance. Therefore, the aim of this experiment was to investigate the effects of a short-term high Se supplementation on physiology, oxidative stress and insulin-related metabolism in heat-stressed pigs. Twenty-four gilts were fed either a control (0.20 ppm Se) or a high Se (1.0 ppm Se yeast, HiSe) diet for 2 weeks. Pigs were then housed in thermoneutral (20°C) or HS (35°C) conditions for 8 days. Blood samples were collected to study blood Se and oxidative stress markers. An oral glucose tolerance test (OGTT) was conducted on day 8 of thermal exposure. The HS conditions increased rectal temperature and respiration rate (both p < .001). The HiSe diet increased blood Se by 12% (p < .05) and ameliorated the increase in rectal temperature (p < .05). Heat stress increased oxidative stress as evidenced by a 48% increase in plasma advanced oxidized protein products (AOPPs; p < .05), which may be associated with the reductions in plasma biological antioxidant potential (BAP) and erythrocyte GPX activity (both p < .05). The HiSe diet did not alleviate the reduction in plasma BAP or increase in AOPPs observed during HS, although it tended to increase erythrocyte GPX activity by 13% (p = .068). Without affecting insulin, HS attenuated lipid mobilization, as evidenced by a lower fasting NEFA concentration (p < .05), which was not mitigated by the HiSe diet. The HiSe diet increased insulin AUC, suggesting it potentiated insulin resistance, although this only occurred under TN conditions (p = .066). In summary, HS induced oxidative stress and attenuated lipid mobilization in pigs. The short-term supranutritional Se supplementation alleviated hyperthermia, but did not protect against oxidative stress in heat-stressed pigs.

Poorer lifetime growth performance of gilt progeny compared with sow progeny is largely due to weight differences at birth and reduced growth in the preweaning period, and is not improved by progeny segregation after weaning.

Gilt progeny (GP) are born and weaned lighter than sow progeny (SP) and have higher rates of mortality. This study aimed to quantify the performance and survival differences between GP and SP throughout the entire production cycle from birth to sale. Furthermore, the study looked at the effects of segregating GP and SP compared with commingling during rearing within common pens. It was hypothesized that GP would be lighter than SP at every age and have lower rates of survival accompanied by higher rates of medication, and that segregating GP and SP would improve the growth and survival of both groups. All progeny born to 109 gilts (parity 1) and 94 sows (parities 2 to 8) were allocated to 4 postweaning treatments at birth: GP separately penned, GP mixed with SP in a common pen (GM), SP separately penned, and SP mixed with GP in a common pen (SM), with littermates split among treatments. The GM and SM pigs were penned together after weaning. Individual live weight of all progeny was recorded at birth (birth weight [BWT]), weaning (28 d; weaning weight [WWT]), 10 wk of age (10-wk weight [10WT]), and sale (22-23 wk; sale weight [SWT]). Individual HCW, backfat depth, loin depth, and dressing percentage were measured at slaughter. All postweaning mortalities and medications were recorded. The GP had a lighter BWT ( = 0.032), WWT ( < 0.001), 10WT ( < 0.001), and SWT ( < 0.001) than SP as well as a lower HCW ( < 0.001) and dressing percentage ( = 0.012). Postweaning performance differences were mostly attributable to the lighter WWT of GP compared with that of SP when WWT was fitted as a covariate. The GP had a higher mortality in the immediate postweaning period (weaning to 10 wk of age; = 0.028) and from weaning to sale ( = 0.012) than SP, which was also attributable to lower WWT. The GP exhibited a higher incidence of mortality ( = 0.011) due to respiratory tract infection in the grower-finisher period, despite similar medication rates ( = 0.83). Segregation of GP and SP between pens presented no benefit in terms of growth and survival of both groups while requiring added labor and production considerations and, therefore, is not recommended. This study confirms that GP are lighter than SP, on average, at every stage of life from birth to slaughter and that their performance before weaning is an important determinant for whole-of-life performance.

Reducing rumen starch fermentation of wheat with three percent sodium hydroxide has the potential to ameliorate the effect of heat stress in grain-fed wethers.

Selection for high productivity has resulted in ruminants adversely affected by heat stress (HS) due to their high metabolic rate and feed intake. One mechanism to ameliorate HS is to reduce the forage-to-concentrate ratio in the diet, although the inclusion of readily fermentable grains can reduce heat tolerance. The aim of these experiments was to investigate a chemical method for reducing the rate of fermentation of wheat and its effect on improving heat tolerance in sheep. In the first experiment, fermentation kinetics and buffered rumen fluid pH variation during in vitro incubation of corn, wheat, and 3% NaOH-treated wheat grains were compared. This experiment showed that corn and 3% NaOH-treated wheat had a slower (-23 and -22%, respectively; < 0.001) rate of gas production and elevated buffered rumen fluid pH ( < 0.001) compared with wheat. In the second experiment, 31 Merino × Poll Dorset wethers were housed in 2 climate-controlled rooms and were fed either corn grain plus forage (42.7% starch; were fed either corn grain plus forage (CD), wheat grain plus forage (WD) or 3 % NaOH-treated wheat plus forage (TWD) during 3 experimental periods: period 1 (P1), which consisted of 7 d of thermoneutral conditions (18 to 21°C and 40 to 50% relative humidity) and 1.7 times maintenance feed intake; period 2 (P2), which consisted of 7 d of HS (28 to 38°C and 30 to 50% relative humidity) and the same feed intake as in P1; and period 3 (P3), which consisted of 7 d of HS as in P2 and 2 times maintenance feed intake in a randomized control experiment. Water was offered ad libitum. The impact of HS was quantified by increases in rectal temperature, respiration rate (RR), and flank skin temperature (FT); variations in blood acid-base balance; and glucose, NEFA, and heat shock protein 70 (HSP-70) plasma concentrations. All physiological variables were elevated during HS, especially when wethers had greater feed intake (P3). Wethers fed CD had lower RR, rectal temperature, and FT than wethers fed WD ( < 0.001) and wethers fed TWD had lower RR and FT than wethers fed WD during HS ( < 0.05). There were reductions in blood CO, HCO3, and base excess concurrent with increases in blood partial pressure of O and pH during HS ( < 0.05). Heat stress reduced plasma NEFA and glucose concentrations whereas it increased prolactin ( < 0.05). Prolactin and HSP-70 plasma concentrations were greater for WD-fed wethers ( < 0.001) associated with Prolactin and HSP-70 plasma concentrations were greater for WD fed wethers (P < 0.001) during HS. These data indicate that the slow rate of rumen fermentation of CD and TWD can reduce the heat released during feed fermentation in the rumen, improving heat tolerance in sheep.

Effects of chromium supplementation on physiology, feed intake, and insulin related metabolism in growing pigs subjected to heat stress.

Improving insulin sensitivity may reduce impacts of heat stress (HS) in pigs by facilitating heat dissipation. Chromium (Cr) has been reported to improve insulin sensitivity in pigs. Therefore, the aim of this experiment was to investigate whether Cr supplementation can mitigate HS in growing pigs. Thirty-six gilts were randomly assigned to 2 diets containing 0 (control) or 400 ppb Cr. After 14 d the supplemented pigs were allocated to either 8 d thermoneutral (20°C constant; TN) or cyclic HS (35°C, 0900 h to 1700 h) conditions and continued their respective diet (n = 9 per group). Growth performance was recorded during the 14-d supplementation period. The physiological responses to HS were monitored by measuring respiration rate, rectal temperature, blood gas chemistry, and feed intake during thermal exposure. Kinetics of plasma glucose, insulin and NEFA were studied by intravenous glucose tolerance test (IVGTT) on d 8 of thermal treatment. Results showed Cr alleviated the HS-increased rectal temperature (P < 0.05) and respiration rate (P < 0.01) at 1300 h and 1600 h during thermal exposure. However, Cr did not mitigate the reduction in average daily feed intake which was reduced by 35% during HS or the HS-induced respiratory alkalosis. Chromium tended to increase average daily gain (0.86 vs. 0.95 kg, P = 0.070) during the 14-d supplementation under TN conditions before thermal exposure, which might be associated with the potential of Cr in improving overall insulin sensitivity, as evidenced by a reduced insulin resistance index calculated by Homeostatic Model Assessment (HOMA-IR; 0.65 vs. 0.51, P = 0.013) and a tendency of reduced fasting plasma insulin concentration (1.97 vs. 1.67 µU/mL, P = 0.094). Heat stress decreased the acute insulin releasing rate (P = 0.012) and consequently slowed glucose clearance rate (P = 0.035) during IVGTT. Besides, HS enlarged the values of area under the curve of NEFA during IVGTT (P < 0.01), indicating a reduced lipid mobilization. In conclusion, HS reduced insulin response to IVGTT. Chromium supplementation exhibited a potential in improving insulin sensitivity and mitigating HS symptoms in growing pigs.

Feeding slowly fermentable grains has the potential to ameliorate heat stress in grain-fed wethers.

During heat stress (HS), livestock reduce metabolic heat production by lowering activity and feed intake. Because this has obvious consequences for productivity, the aim of these experiments was to investigate nutritional methods for reducing digestive metabolic heat production, thereby allowing livestock more opportunity to dissipate excess heat. In the first experiment, the fermentation rates of corn and wheat grains were compared in an in vitro gas production system containing buffered rumen fluid. This experiment showed that corn had a slower (-15%; < 0.001) rate of gas production than wheat and no differences in total amount of gas production after 24 h of incubation. In the second experiment, we hypothesized that the lower rate of fermentation of corn would reduce metabolic heat load in wethers and, in turn, improve tolerance to HS. Twenty-two Merino × Poll Dorset wethers were housed in 2 climate-controlled rooms and were fed either corn grain plus forage (CD; 39% starch) or wheat grain plus forage (WD; 37% starch) during 3 experimental periods: period 1 (P1), which consisted of 7 d of thermoneutral conditions (18 to 21°C and 40 to 50% relative humidity [RH]) and restricted feed intake (1.3 times maintenance); period 2 (P2), which consisted of 7 d of HS (28 to 38°C and 30 to 50% RH) and restricted feed intake; and period 3 (P3), which consisted of 7 d of HS as in P2 with unrestricted feed intake (1.5 times maintenance) in a randomized control experiment. Water was offered ad libitum. The level of HS was quantified by increases in rectal temperature (RT), respiration rate (RR), and left and right flank skin temperature (LFT and RFT, respectively) and blood acid-base balance. Rectal temperature, RR, LFT, and RFT were elevated ( < 0.001) during HS, especially when wethers had unrestricted feed intake (P3). Wethers fed CD had lower RR, RT, LFT, and RFT ( < 0.001) than wethers fed WD, and this benefit was greatest during HS (P2 and P3). The reduction in RR with CD resulted in less CO exhalation (greater partial pressure of CO2) and greater HCO3 ( < 0.05) than with WD, indicating reduced efforts to dissipate heat by evaporative heat loss via panting. The greatest heat from fermentation was apparent in WD wethers, which had elevated LFT compared with RFT ( < 0.001). Crucially, this large difference was not observed with the CD wethers, indicating that the slow rate of fermentation of CD was expressed as low heat released during feed fermentation in the rumen. These data demonstrated that feeding CD may be a useful management strategy to reduce the impact of high environmental heat loads in sheep.

Application of small angle X-ray scattering synchrotron technology for measuring ovine meat quality.

A small angle X-ray scattering (SAXS) synchrotron was used to evaluate 100 ovine m. longissimus lumborum, representing lamb (n=50) and sheep (n=50). The diffraction of X-rays gives information on muscle myofibril structure and fat content. The linear relationships between SAXS measures with measures such as, shear force, intramuscular fat content (IMF) and collagen content/solubility, were investigated. A relationship was found between the d-spacing of the actin/myosin fibril spacing (SAX1 and SAX2) and the cross sectional area of the rhombohedral unit cell (Cell area) and shear force after 1 and 5day ageing. There was a positive relationship between IMF and a SAXS Fat area measure. There was a muscle site effect on SAX1, SAX2 and Cell area, with the cranial site having a larger distance between myofibrils. The potential of SAXS as a powerful research tool to determine not only the structural components of ovine tenderness, but also the fat content related to IMF is evident.

COMPARATIVE GUT PHYSIOLOGY SYMPOSIUM: Comparative physiology of digestion.

The digestive systems of all species have been shaped by environmental pressures over long evolutionary time spans. Nevertheless, all digestive systems must achieve the same end points, the ingestion of biological material and its conversion to molecules that serve as energy substrates and structural components of tissues. A range of strategies to extract nutrients, including for animals reliant primarily on foregut fermentation, hindgut fermentation, and enzymatic degradation, have evolved. Moreover, animals have adapted to different foodstuffs as herbivores (including frugivores, folivores, granivores, etc.), carnivores, and omnivores. We present evidence that humans have diverged from other omnivores because of the long history of consumption of cooked or otherwise prepared food. We consider them to be cucinivores. We present examples to illustrate that the range of foodstuffs that can be efficiently assimilated by each group or species is limited and is different from that of other groups or species. Differences are reflected in alimentary tract morphology. The digestive systems of each group and of species within the groups are adaptable, with constraints determined by individual digestive physiology. Although overall digestive strategies and systems differ, the building blocks for digestion are remarkably similar. All vertebrates have muscular tubular tracts lined with a single layer of epithelial cells for most of the length, use closely related digestive enzymes and transporters, and control the digestive process through similar hormones and similarly organized nerve pathways. Extrapolations among species that are widely separated in their digestive physiologies are possible when the basis for extrapolation is carefully considered. Divergence is greatest at organ or organismal levels, and similarities are greatest at the cell and molecular level.

Effects of infusing nitric oxide donors and inhibitors on plasma metabolites, muscle lactate production and meat quality in lambs fed a high quality roughage-based diet.

As nitric oxide (NO) is postulated to be a mediator of the effects of pre-slaughter stress on meat quality the aims of this experiment were to investigate the effects of modulating NO pharmacologically on meat quality of sedentary lambs. As pharmacological NO donors are prohibitively expensive to use in the lamb model L-Arginine, the substrate for NO synthase (NOS) was infused into lambs and increased NO production by ~30%. In a 2 × 2 factorial design we infused either L-Arginine (500 mg/kg) or the NOS inhibitor L-N(G) nitroarginine methyl ester hydrochloride (L-NAME, 30 mg/kg) 190 min pre-slaughter and investigated meat quality in the Longissimus thoracis lumborum (LTL) or Semimembranosus (SM). The principal outcome of the experiment was that L-NAME inhibited proteolysis and reduced tenderness in the SM. These data indicate that events pre-slaughter that affect NO synthesis can influence meat tenderness, potentially via altered muscle metabolism or modulation of proteolytic enzymes.

Inhibition of nitric oxide release pre-slaughter increases post-mortem glycolysis and improves tenderness in ovine muscles.

The aim of this experiment was to determine the effect of inhibiting the release of nitric oxide (NO) pre-slaughter in lambs on post-slaughter muscle metabolism and meat quality. Exercise was used as a positive control as NO is known to be released in skeletal muscle during exercise. Forty Border Leicester×Merino lambs were assigned to the treatments L-NAME (NO synthase inhibitor) infusion (0mg/kg vs. 30mg/kg, 135min pre-slaughter) and exercise (none vs. 15min immediately pre-slaughter). The inhibition of NO release using L-NAME reduced Warner-Bratzler shear force (WBSF) in the longissimus thoracis et lumborum (LTL) after 3days of ageing, while the Semimembranosous (SM) was unaffected. Inhibition of NO release with L-NAME resulted in altered glucose metabolism as indicated by reduced plasma glucose pre-slaughter particularly in exercised lambs, reduced LTL and SM glycogen of non-exercised lambs post-slaughter and increased SM lactate in exercised lambs post-slaughter. In conclusion, inhibition of NO Synthase with L-NAME pre-slaughter increases post-mortem glycolysis and improves tenderness in the loin muscle.

Glucagon-like peptide-2 protects against TPN-induced intestinal hexose malabsorption in enterally refed piglets.

Premature infants receiving chronic total parenteral nutrition (TPN) due to feeding intolerance develop intestinal atrophy and reduced nutrient absorption. Although providing the intestinal trophic hormone glucagon-like peptide-2 (GLP-2) during chronic TPN improves intestinal growth and morphology, it is uncertain whether GLP-2 enhances absorptive function. We placed catheters in the carotid artery, jugular and portal veins, duodenum, and a portal vein flow probe in piglets before providing either enteral formula (ENT), TPN or a coinfusion of TPN plus GLP-2 for 6 days. On postoperative day 7, all piglets were fed enterally and digestive functions were evaluated in vivo using dual infusion of enteral ((13)C) and intravenous ((2)H) glucose, in vitro by measuring mucosal lactase activity and rates of apical glucose transport, and by assessing the abundances of sodium glucose transporter-1 (SGLT-1) and glucose transporter-2 (GLUT2). Both ENT and GLP-2 pigs had larger intestine weights, longer villi, and higher lactose digestive capacity and in vivo net glucose and galactose absorption compared with TPN alone. These endpoints were similar in ENT and GLP-2 pigs except for a lower intestinal weight and net glucose absorption in GLP-2 compared with ENT pigs. The enhanced hexose absorption in GLP-2 compared with TPN pigs corresponded with higher lactose digestive and apical glucose transport capacities, increased abundance of SGLT-1, but not GLUT-2, and lower intestinal metabolism of [(13)C]glucose to [(13)C]lactate. Our findings indicate that GLP-2 treatment during chronic TPN maintains intestinal structure and lactose digestive and hexose absorptive capacities, reduces intestinal hexose metabolism, and may facilitate the transition to enteral feeding in TPN-fed infants.

Effects of nitric oxide and oxidation in vivo and postmortem on meat tenderness.

Metabolic processes in muscle tissue in vivo result in the production of reactive oxygen species and oxidative compounds including superoxide anions and nitric oxide (NO). Reactive oxygen species can react with both lipids and proteins and often have deleterious effects, contributing to the onset of ageing and senescence as well as cell death. Nitric oxide (NO) is a free radical that is constantly produced or released throughout the body by diverse tissues and is known to influence proteolytic activity in human and rodent skeletal muscle as well as being involved in regulation of calcium homeostasis in the muscle cell. The influence of nitric oxide on development of meat tenderness has been studied through postmortem manipulation and also through in vivo studies. The effect of NO on meat tenderness is postulated to be via its regulatory effects on the proteins calpain, cathepsins, ryanodine receptor channel in the sarcoplasmic reticulum (SR) and the sarcoplasmic-endoplasmic release calcium ATPase in the SR. NO is an oxidant although the effects of NO on effector proteins can be distinguished from a direct oxidation reaction. The onset of oxidation in meat postmortem is well known to produce off-odours, discolouration and unacceptable flavours associated with rancidity. Oxidation during the immediate postmortem period appears to inhibit tenderisation during ageing, probably through an inhibitory effect of oxidation on the calpain enzyme. Oxidation of muscle tissue occurring as a result of availability of oxygen during modified atmosphere packaging may also have deleterious consequences for tenderness development during storage of meat prior to retail display. In conclusion, it is proposed that postmortem meat tenderisation is influenced by skeletal muscle's release of NO pre-slaughter and the oxidation of proteases postmortem. This proposal is compatible with the existing tenderness model and will hopefully assist in increasing the accuracy of prediction of meat tenderness. Future directions for research are discussed.

Inhibition of endogenous nitric oxide production influences ovine hindlimb metabolism independently of insulin concentrations.

The hindlimb arteriovenous difference (AVD) model was used to determine whether 30 mg/ kg of the nitric oxide synthase (NOS) inhibitor L-NGnitroarginine methyl ester (hydrochloride; L-NAME) inhibited ovine NO synthesis and influenced muscle metabolism. Eight Border Leicester x Merino cross lambs (50 to 55 kg BW) were infused with saline (control) or saline containing L-NAME via an indwelling jugular vein catheter in a balanced randomized crossover design with 3 d between treatments. The abdominal aorta and deep femoral vein were catheterized for assessment of AVD of hind limb metabolism. Arterial hematocrit and insulin concentration and both arterial and venous concentrations of nitrate/nitrite (NOx), glucose, lactate, NEFA, and urea were determined. Infusion of L-NAME decreased arterial NOx concentrations (P = 0.049), indicating inhibition of systemic NO synthesis. Treatment had no effect on arterial (3.5 vs. 3.6 +/- 0.19 mmol/L for control and L-NAME lambs, respectively; P = 0.39) or venous (3.3 vs. 3.4 +/- 0.16 mmol/L, P = 0.55) plasma glucose concentrations or on glucose AVD (0.19 vs. 0.27 +/- 0.065 mmol/L, P = 0.20). There was an interaction (P = 0.038) between time and treatment, such that L-NAME initially increased the AVD of glucose (up to 180 m) divergent from control lambs. The response was then decreased before a possible inflection beyond 240 min. Infusion of L-NAME increased hindlimb venous NEFA (222 vs. 272 +/- 13.2 micromol/L, P = 0.007) and NEFA AVD (79.4 vs. -13.3 +/- 31.5 micromol/L, P = 0.018). These metabolic changes were independent of plasma insulin concentrations, which were not affected by L-NAME infusion (25.3 vs. 27.8 +/- 3.62 mU/L, P = 0.85). The increase in hindlimb lipolysis after L-NAME infusion does not seem to be due to increased lipolysis of plasma triacylglycerol because circulating arterial (155 vs. 142 +/- 20.8 micromol/L, P = 0.58), venous (154 vs. 140 +/- 20.5 micromol/L, P = 0.50), and AVD (1.0 vs. 2.9 +/- 3.17 micromol/L, P = 0.38) triacylglycerol concentrations were unaffected by L-NAME infusion. In conclusion, these data indicate that infusion of 30 mg of L-NAME/kg inhibits NO synthesis, which in turn influences fat and carbohydrate metabolism in the ovine hindlimb independently of plasma insulin concentrations.

Effects of prognosis, perceived benefit, and decision style on decision making and critical care on decision making in critical care.

OBJECTIVE: To assess the effects of prognostic estimates, perceived benefit of treatment, and practice style on decision-making in critical care. DESIGN: Randomized assignment of subjects to either of two versions of a questionnaire designed to elicit treatment decisions for six intensive care unit cases based on actual patients. One version offered optimistic survival forecasts; the other, pessimistic forecasts. SUBJECTS: A random sample of 120 clinicians obtained from the Canadian Critical Care Society was contacted by mail. One version of the questionnaire was randomly assigned and mailed to each. Thirty-four replies, 17 for each version (response rate, 28%), were received and analyzed. MEASUREMENTS AND MAIN RESULTS: A list of treatment/management options was developed for each case, in three categories: recommended, questionable, and unacceptable. Subjects were also able to list new options that they would order that were not on the list. The dependent variables were the number of actions ordered in each category and the total for each case. Perceived benefit was measured by comparing subjective estimates of the probability of survival with the optimistic/pessimistic forecast given in the case. Practice style was assessed by correlating the total number of actions ordered across all possible pairs of cases. There were no significant differences between the two questionnaires on actions ordered either by category or by amount per category. Perceived benefit did not appear to be an important factor in decision-making. However, statistically significant correlations provide evidence for practice style in intensive care unit decision-making on an interventionist/noninterventionist dimension. CONCLUSIONS: There is no evidence that erroneous or biased prognostic estimates affect intensive care unit treatment choices. Neither the principle of maximizing expected utility nor the Rule of Rescue appear to affect these decisions systematically, but practice style does.

Inflight arterial saturation: continuous monitoring by pulse oximetry.

The ability of newer airliners to fly at higher altitudes has resulted in an increased altitude exposure to both airline crews and passengers. This increase in altitude exposure has the potential to place some individuals at risk for desaturation. Using pulse oximetry, the arterial oxygen saturation of 42 airline crew members was continuously monitored on 22 regularly scheduled commercial flights. Mean nadir arterial oxygen saturations fell from 97.0% preflight to 88.6% at cruising altitudes. Pulse oximetry results revealed large variations between individuals. Individual nadir saturations ranged from 93% to 80%. Modern aircraft flight may result in desaturations even among healthy aircrew. The effects on human performance remain unknown.

Home oxygen therapy. A comparison of 2- vs 6-month patient reevaluation.

STUDY OBJECTIVE: To contrast the effectiveness of 2- vs 6-month reevaluation intervals on both clinical outcome and cost in patients requiring continuous home oxygen therapy (HOT). DESIGN: Prospective, randomized clinical trial. SETTING: The outpatient program of a university-affiliated Veterans Affairs Medical Center (VAMC) Pulmonary Service. PATIENTS: Fifty patients were chosen from among a cohort of 200 patients currently enrolled in our HOT program. All met specific arterial blood gas criteria, were able to give informed consent, had at least 6 months of prior HOT usage, and did not have any illness expected to independently shorten life expectancy. INTERVENTIONS: Baseline resting oxygen flow rates were prescribed based on the results of arterial blood gas measurements so as to attain a PaO2 > 60 mm Hg. Flow rates were adjusted as needed during a 12-min walk to maintain pulse oximetry readings > 90%. No adjustments in baseline flow rates were made during sleep. Identical evaluations were repeated at either 2- or 6-month intervals. MEASUREMENTS AND RESULTS: At 1-year follow-up, there were no significant differences between the 2- and 6-month groups in any of the clinical outcome parameters measured, ie, number of emergency department visits, number of hospitalizations, number of days hospitalized, or mortality. Total costs were not significantly different between the two groups. Evaluation costs were less in the 6-month follow-up group. CONCLUSIONS: After attaining stability following at least 6 months of continuous HOT usage, patients receiving continuous HOT need not be routinely reevaluated more frequently than every 6 months.