[Hyperammonemia during total parenteral nutrition in children]

Twenty-one children presenting with severe malnutrition were fed with total parenteral nutrition using 2 different aminoacids solutes containing 19% and 42% branched chain aminoacids respectively. With the 42% branched chain aminoacids solute a dysregulation of ammonia metabolism and changes in protein synthesis were observed. Several factors probably accounted for these changes. An excessive intake of branched chain aminoacids in children with malnutrition, under parenteral nutrition, is therefore iatrogenic and inappropriate.