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Intravenous amino acids and stimulation of gastric acid secretion in infants
Insights
Intravenous amino acids significantly increase gastric acid secretion in infants. This finding is crucial for understanding infant nutrition and gastrointestinal health during parenteral nutrition.
Area of Science:
- Pediatric Gastroenterology
- Neonatal Nutrition
- Gastrointestinal Physiology
Background:
- Infants requiring intravenous supplements often have altered nutritional intake.
- Parenteral nutrition is common in chronically ill infants.
- The effect of intravenous amino acids on infant gastric acid secretion is not well understood.
Purpose of the Study:
- To investigate the immediate impact of intravenous amino acids on gastric acid secretion in infants.
- To quantify the short-term stimulation of gastric acid output by amino acid infusion.
Main Methods:
- Nine enterally fed, chronically ill infants requiring intravenous supplements participated.
- Gastric acid secretion was measured via continuous aspiration of gastric contents.
- Acid output was assessed before and during a 4-hour infusion of intravenous amino acids at 0.15 g/kg/h.
Main Results:
- Intravenous amino acid infusion led to a twofold increase in gastric acid secretion.
- Stimulated acid output was significantly higher than basal levels (p < 0.01) during hours 3 and 4.
- Serum gastrin levels did not change significantly before and after amino acid infusion.
Conclusions:
- Amino acids administered intravenously at typical parenteral nutrition rates stimulate gastric acid secretion in infants.
- This stimulation occurs independently of significant changes in serum gastrin levels.
- Findings have implications for managing gastrointestinal function in infants receiving parenteral nutrition.
Abstract:
To determine the immediate, short-term effect of intravenous amino acids on gastric acid secretion in infants, we measured acid secretion by continuous aspiration of gastric contents in nine enterally fed, chronically ill infants who required intravenous supplements. On day 1, basal acid output was 25 +/- 15 mumol/kg/h (mean +/- SD), and postpentagastrin maximal acid output was 91 +/- 59 mumol/kg/h. On day 2 basal acid output was 24 +/- 16 mumol/kg/h. Acid output was measured for 4 h following addition of amino acids to the intravenous solution. The rate of amino acid infusion was 0.15 g/kg/h. The infusion of intravenous amino acids resulted in an immediate and sustained twofold increase in acid secretion. Hourly totals of amino acid-stimulated acid output were 51 +/- 38, 44 +/- 37, 46 +/- 30, and 47 +/- 31 mumol/kg/h in hours 1-4, respectively. These results were significantly different from basal acid output (p less than 0.01) during the last 2 h of amino acid infusion. Serum gastrin concentration was not significantly different before and after the amino acid infusion (87 +/- 63 pg/ml vs. 105 +/- 56 pg/ml). We conclude that amino acids infused at a rate typical for parenteral nutrition stimulate gastric acid secretion in infants.