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Early changes in plasma amino acid concentrations during aggressive nutritional therapy in extremely low birth weight

Cynthia Liudmilla Blanco1, Alice Kim Gong, Belinda Kay Green

  • 1Department of Pediatrics, University of Texas Health Science Center, San Antonio, TX 78229-3900, USA. blanco@uthscsa.edu

The Journal of Pediatrics
|December 7, 2010
PubMed

Insights

Early and high intravenous amino acid (AA) supplementation in extremely low birth weight infants led to significantly higher plasma AA concentrations compared to standard AA regimens. This highlights the impact of early, aggressive AA delivery on neonatal nutrient status.

Area of Science:

  • Neonatal nutrition
  • Biochemistry
  • Pediatric intensive care

Background:

  • Extremely low birth weight (ELBW) infants often require parenteral nutrition, including amino acids (AA), for growth and development.
  • Optimizing AA delivery is crucial for ELBW infants to prevent deficiencies and support metabolic processes.
  • The timing and dosage of intravenous AA supplementation can influence plasma AA levels.

Purpose of the Study:

  • To compare plasma amino acid (AA) concentrations in ELBW infants receiving standard vs. early and high intravenous AA supplementation.
  • To evaluate the impact of different AA supplementation strategies on essential and nonessential AA levels over the first week of life.

Main Methods:

  • A randomized, double-masked, prospective study involving 62 ELBW infants over 7 days.
  • Two groups: standard AA (0.5-3 g/kg/d) and early and high AA (2-4 g/kg/d).
  • Plasma AA concentrations measured by high-pressure liquid chromatography on days 1, 3, and 7.

Main Results:

  • The early and high AA group showed significantly higher total, essential, and nonessential AA concentrations.
  • Differences in essential and total AA were observed on days 1 and 3; nonessential AA differences were noted on day 3.
  • Specific nonessential AAs (Glu, Asn, Gly, Gln, Ala, Tyr) and Cys did not show significant differences between groups.

Conclusions:

  • Early and higher parenteral AA supplementation results in elevated plasma AA concentrations in ELBW infants.
  • This feeding strategy may be beneficial for achieving adequate AA levels in vulnerable neonates.
Abstract

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