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Amino acid administration to premature infants directly after birth

Frans W J te Braake1, Chris H P van den Akker, Darcos J L Wattimena

  • 1Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.

The Journal of Pediatrics
|October 18, 2005
PubMed

Insights

Early administration of amino acids (AA) to very low birth weight infants is safe and promotes positive nitrogen balance, leading to an anabolic state. This nutritional strategy supports growth in vulnerable preterm neonates.

Area of Science:

  • Neonatal Nutrition
  • Pediatric Gastroenterology
  • Intensive Care Medicine

Background:

  • Very low birth weight (VLBW) infants (<1500 g) are at risk for nutritional deficiencies.
  • Early nutritional support is crucial for growth and development in preterm neonates.
  • Optimizing amino acid (AA) delivery is essential for achieving an anabolic state.

Purpose of the Study:

  • To evaluate the safety and efficacy of early, high-dose amino acid (AA) administration in VLBW infants.
  • To determine if administering 2.4 g AA/(kg.d) from birth results in a positive nitrogen balance.
  • To assess the impact of early AA supplementation on biochemical markers and clinical outcomes.

Main Methods:

  • Randomized clinical trial comparing two AA administration strategies in preterm infants.
  • Group 1: Continuous AA infusion (2.4 g/kg/d) from birth.
  • Group 2: Stepwise AA increase to 2.4 g/kg/d by day 3; monitoring of blood gases, urea nitrogen, AA levels, and nitrogen balance.

Main Results:

  • No significant adverse side effects were observed in infants receiving early AA supplementation.
  • Early AA administration led to a positive nitrogen balance, indicating an anabolic state.
  • Higher blood urea nitrogen levels and more AA plasma concentrations within reference ranges were noted in the early AA group.

Conclusions:

  • High-dose amino acid (AA) administration can be safely initiated from birth in VLBW infants.
  • Early AA supplementation effectively promotes an anabolic state, supporting growth.
  • This strategy represents a safe and beneficial approach to neonatal nutrition.
Abstract

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