Early amino acids and the metabolic response of ELBW infants (⩽1000 g) in three time periods

Radmacher, Paula G.; Lewis, S.; Adamkin, David H.

doi:10.1038/jp.2009.36

Cited by 37 publications

(19 citation statements)

References 26 publications

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“…18 Our findings of the importance of the type of calories supplied for in-hospital preterm growth have been emphasized by other investigators. [14][15][16][24][25][26][27][28][29][30] In 1998, Carlson and Zeigler 24 published a longitudinal study of 51 preterm infants and their protein intake, energy intake and subsequent growth. Regression analysis suggested that protein intake related positively to growth.…”

Section: Discussionmentioning

confidence: 99%

Randomized trial of enteral protein and energy supplementation in infants less than or equal to 1250 g at birth

Brumberg

Kowalski²,

Troxell-Dorgan

et al. 2010

J Perinatol

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Objective: To determine if enteral protein and energy supplementation would significantly improve weight gain as compared with energy supplementation alone in p1250 g infants.Study Design: Inclusion criteria were birth weight (BW) p1250 g, postnatal age X14 days, diet of X75% enteral nutrition (fortified human milk or formula) and either failure to regain BW or weight gain<15 g kg À1 per days. Infants were randomized to a multinutrient supplement that provided increased protein and energy (P/E) intake or energy alone (medium chain triglyceride oil, MCT). Growth rates were compared at the end of the 4-week study period.Result: Of 30 eligible infants, 23 were enrolled, 12 received MCT (BW ¼ 862 ± 252 g, mean ± s.d.) and 11 received P/E (BW ¼ 879 ± 241 g). Significantly higher protein intake (P/E ¼ 3.5±0.3 g kg À1 per day, MCT ¼ 3.0±0.5 g kg À1 per day) and better growth (P/E ¼ 17.0 ± 2.4 g kg À1 per day, MCT ¼ 11.5±4.8 g kg À1 per day) were observed in the P/E group.Conclusion: These data are consistent with the importance of providing additional daily protein intake to achieve increased postnatal growth in very low birth weight infants experiencing slow growth.

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Section: Discussionmentioning

confidence: 99%

Randomized trial of enteral protein and energy supplementation in infants less than or equal to 1250 g at birth

Brumberg

Kowalski²,

Troxell-Dorgan

et al. 2010

J Perinatol

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“…Radmacher demonstrated a modest increase in urea as the AA dose was increased. 9 Blanco demonstrated higher urea levels in the early high amino acid (EHAA) group as compared with the standard amino acid (SAA) group during the first week of life. 13 Braake showed that in conjunction with the higher blood urea nitrogen (BUN) levels, the higher amounts of excreted nitrogen in the EHAA group indicated a higher oxidation rate.…”

Section: Discussionmentioning

confidence: 99%

“…8 Early administration of AA has been shown to be safe and promotes positive nitrogen balance in preterm infants. 2,9 Some authors have studied the relationship of EPN with the weight gain in preterm infants. A prospective study by Valentine et al compared 308 preterm VLBW infants who received EPN supplementation with 132 infants who did not receive EPN.…”

Section: Discussionmentioning

confidence: 99%

Early Versus Late Parenteral Nutrition in Very Low Birthweight Neonates : A Retrospective Study from Oman

Aroor¹,

Krishnan²,

Reyes³

et al. 2012

SQUMJ

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(EPN group, n = 44). Demographic data, anthropometric and laboratory parameters were extracted from the electronic record system. Results: The mean age of PN initiation was LPN = 47.3 hours versus EPN = 14.3 hours. Biochemical parameters analysed during the first week of life revealed a reduction in hypernatraemia (12.7% versus 6.8%) and non-oliguric hyperkalemia (12.7% versus 6.8%) in EPN, with no significant differences in acidosis and urea levels between the two groups. Hyperglycemia >12 mmol/L in <1000g was higher in EPN. Nutritional parameters in 81 babies who survived/stayed in the unit up to a corrected gestational age (CGA) of 34 weeks (40 in LPN and 41 in EPN), revealed a reduction in metabolic bone disease (osteopenia of prematurity [OOP], 17.5% versus 7.3%) and the need for phosphate supplementation (22.5% versus 7.3%) in the EPN group. There was no increase in acidosis or cholestasis. No difference was noted in albumin levels, time to full feeds, time to regain birthweight and mean weight gain per day till 34 weeks corrected CGA. Conclusion: EPN in VLBW newborns is well tolerated and reduces hypernatraemia, non-oliguric hyperkalemia, OOP and the need for phosphate supplementation. Early versus Late Parenteral Nutrition in VeryLow Birthweight Neonates A retrospective study from Oman 1 They are traditionally started on a dextrose infusion and graded to parenteral nutrition (PN) over several days. The goal of EPN is to provide an intravenous substrate that promotes protein deposition and increased lean body mass that approximates fetal growth rate and accretion. In recent years, early introduction and aggressive advancement of PN have been shown to be safe and effective.2,3 Protein delivery of 3 gm/kg beginning on day one (D1) of life is safe and associated with plasma AA concentrations similar to those of second and third trimester fetuses. 4 In the absence of iatrogenic causes of electrolyte and acid base derangements, significant individual variations in nutritional requirements of preterm neonates from PN are rare. 5 Hypothesising that premature infants might benefit from the anabolic effects of EPN without metabolic derangement, we investigated the benefits of EPN in VLBW neonates. The objectives of our study were to compare the following between the EPN and LPN groups: 1) Biochemical disturbances in the first week of life; 2) Weight gain/day, mean weight at 34 weeks corrected gestational age (CGA), time to full feeds and time to regain birth weight, and 3) Incidence of osteopenia, the need for phosphate supplementation, cholestasis and albumin levels. The study included all inborn VLBW babies between and including gestational age 25-32weeks and weighing ≤1500 g; those that survived >7days for assessing biochemical parameters; infants who survived/stayed in the NICU until corrected gestational age (CGA) of 34 weeks for assessing nutritional parameters, and who received PN for >5 days. Excluded from this study were infants with chromosomal and major congenital anomalies; those on PN for >4weeks; ba...

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“…They also found there to be no relationship between BUN and protein intake. 24 There are several randomized controlled trials that have evaluated the effects of protein administration in VLBW infants and which have found early administration of amino acids to be well tolerated. Wilson et al randomized 125 VLBW infants to an aggressive parenteral and enteral nutritional regimen (goal protein load of 2.5 to 3.5 g/kg/day) versus a controlled conservative nutritional regimen (goal protein load of 2.5 g/kg/day).…”

Section: Discussionmentioning

confidence: 99%

Blood urea nitrogen and serum bicarbonate in extremely low birth weight infants receiving higher protein intake in the first week after birth

et al. 2011

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Early amino acids and the metabolic response of ELBW infants (⩽1000 g) in three time periods

Cited by 37 publications

References 26 publications

Randomized trial of enteral protein and energy supplementation in infants less than or equal to 1250 g at birth

Randomized trial of enteral protein and energy supplementation in infants less than or equal to 1250 g at birth

Early Versus Late Parenteral Nutrition in Very Low Birthweight Neonates : A Retrospective Study from Oman

Blood urea nitrogen and serum bicarbonate in extremely low birth weight infants receiving higher protein intake in the first week after birth

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