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Early parenteral feeding of amino acids
J Saini1, P MacMahon, J B Morgan
1Department of Child Health, Charing Cross and Westminster Medical School, London.
Insights
Early parenteral amino acid (AA) administration in preterm infants significantly improves early nutritional status. Starting AA within 24 hours of birth enhances nitrogen and energy balance in the first three days of life.
Area of Science:
- Neonatal Nutrition
- Pediatric Intensive Care
- Metabolic Balance Studies
Background:
- Preterm infants often require nutritional support due to immature digestive systems.
- Ventilator-dependent infants face unique challenges in achieving adequate nutrient intake.
- Early nutritional status is critical for the growth and development of premature neonates.
Purpose of the Study:
- To investigate the impact of early versus delayed parenteral amino acid administration on nitrogen and energy balance in ventilator-dependent preterm infants.
- To assess the short-term nutritional benefits of initiating amino acid therapy within 24 hours of birth.
Main Methods:
- Conducted serial 24-hour balance studies over 10 days in two groups of preterm infants.
- One group received parenteral amino acids (Vamin 9) within 24 hours of birth; the other group started at 72 hours.
- Controlled for comparable weight and gestational age, with identical feeding protocols otherwise.
Main Results:
- Infants receiving early amino acids showed significantly higher nitrogen intake (286 vs. 21 mg/kg/day) and retention (120 vs. -133 mg/kg/day) during the first three days.
- Early AA group also had higher energy intake (188 vs. 151 kJ).
- Nutritional differences diminished by 7-10 days of life.
Conclusions:
- Early introduction of parenteral amino acids significantly improves the early nutritional state of sick preterm infants.
- This intervention positively impacts nitrogen and energy balance in the critical first few days post-birth.
- The benefits appear most pronounced in the immediate neonatal period.
Abstract:
Serial 24 hour balance studies of nitrogen and energy were carried out over 10 days in two groups of ventilator dependent preterm infants, of comparable weight and gestational age. In one group (n = 10) a parenteral amino acid source (Vamin 9) was started within 24 hours of birth, and in the other group (n = 11) it was not started until 72 hours. The feeding protocol was otherwise identical. The nitrogen intake (286 compared with 21 mg/kg/day), energy intake (188 compared with 151 kJ), and nitrogen retention (120 compared with -133 mg/kg/day), were all significantly higher during the first three days of life in the group in which the amino acid solution was started early. There were no differences by 7-10 days. The early introduction of amino acids improves the early nutritional state of sick preterm infants.