Related Experiment Videos
Partial parenteral nutrition in preterm and newborn infants during the first three days of life
Insights
Partial parenteral nutrition with amino acids improved nitrogen balance in preterm infants, even with suboptimal calories. This method showed no adverse effects on weight or amino acid levels, supporting its use in high-risk neonates.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Intensive Care Medicine
Background:
- Preterm infants and neonates with asphyxia or hypotrophy often require nutritional support.
- Optimizing nutritional intake is crucial for growth and development in vulnerable newborns.
- Partial parenteral nutrition (PPN) offers a way to supplement oral feeding.
Purpose of the Study:
- To evaluate the efficacy and safety of PPN using glucose and amino acids in high-risk neonates.
- To assess nitrogen balance and retention during the initial days of life.
- To monitor plasma amino acid levels and weight changes as indicators of nutritional status and tolerance.
Main Methods:
- Eight preterm infants, two hypotrophic neonates, and one term infant with asphyxia received PPN alongside oral nutrition.
- PPN consisted of glucose and a mother's milk-adapted amino acid solution for the first three days.
- Nitrogen balance, plasma amino acid levels (via column chromatography), and weight changes were monitored.
Main Results:
- Positive nitrogen balances were achieved despite calorie intake below the optimal level.
- Nitrogen retention reached approximately 60% of supply on days 2 and 3.
- Plasma amino acid levels remained stable, indicating no homeostatic imbalances.
- Mean weight loss was 4%, comparable to healthy preterm infants.
Conclusions:
- Partial parenteral nutrition with amino acids is effective in achieving positive nitrogen balance in high-risk neonates.
- This nutritional strategy is well-tolerated, with no adverse effects on weight or amino acid profiles.
- PPN can be a valuable component of nutritional management for vulnerable infants.
Abstract:
Eight preterm infants, five with postnatal asphyxia, as well as two hypotrophic neonates and one term infant with severe postnatal asphyxia (mean birth weight 2300 g) were fed, in addition to oral nutrition, partially parenterally with glucose solution and mother's-milk-adapted amino acid solution during their first three days of life. By increasing protein supplies with a parenteral share of more than 50% during the three days, the nitrogen balances were positive on all days, although the calories supplied were far below the postulated optimum. On days 2 and 3, nitrogen retention was about 60% of the supply. Every 4 hrs after discontinuation of the 16 hr amino acid infusion, the amino acid levels in the plasma were examined by column chromatography. The resulting mean values did not show any imbalances of amino acid homeostasis. The maximum mean loss in weight of the present groups was 4% of the birth weight during the first 10 days of life and thus equalled the loss in weight of normal healthy preterms. Clinical and chemical parameters did not reveal any disadvantageous side effects of partial parenteral nutrition.