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Plasma amino acid patterns in very low birth weight infants during parenteral nutrition
G Srinivasan1, A Amin, R S Pildes
1Department of Pediatrics, Cook County Children's Hospital, Chicago Medical School, Illinois 60612.
Insights
Parenteral nutrition with Freamine III altered amino acid levels in premature infants. The protein dose should be reduced for very low birth weight neonates to optimize nutrient balance.
Area of Science:
- Neonatal nutrition
- Biochemistry
- Pediatric medicine
Background:
- Premature neonates require specialized nutritional support.
- Parenteral nutrition is crucial for growth and development in infants unable to feed enterally.
- Amino acid profiles are critical indicators of nutritional status in neonates.
Purpose of the Study:
- To evaluate the impact of Freamine III parenteral nutrition on plasma amino acid levels in very low birth weight infants.
- To determine if the current protein administration recommendations are optimal for this vulnerable population.
Main Methods:
- Eight very low birth weight infants (<= 1000 gm) were enrolled.
- Plasma amino acid concentrations were measured before and after 24 hours of Freamine III infusion.
- Statistical analysis was performed to identify significant changes in amino acid levels.
Main Results:
- Significant increases were observed in threonine, valine, isoleucine, methionine, serine, proline, glycine, and ornithine levels.
- Significant decreases were noted in taurine and tyrosine levels.
- The observed changes suggest suboptimal amino acid balance with current parenteral nutrition protocols.
Conclusions:
- Freamine III, at the prescribed dosage, may not be optimal for premature neonates.
- The recommended protein intake of 2.5-3.0 gm/kg/day may be excessive for infants weighing <= 1000 gm during the first week of life.
- Adjusting protein administration is necessary to improve amino acid homeostasis in extremely preterm infants.
Abstract:
Plasma amino acids were measured in eight very low birth weight infants (less than or equal to 1000 gm) before and after infusion of parenteral alimentations with Freamine III. Significant elevation in serum threonine, valine, isoleucine, methionine, serine, proline, glycine and ornithine was noted after twenty four hours of infusion. On the other hand, significant decreases in taurine and tyrosine levels were noted. Our study suggests that current solution is not optimal for premature neonates and the amount of protein administered during the first week in infants weighing less than or equal to 1000 gm should be decreased from the recommended 2.5-3.0 gm/kg/day.