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Plasma amino acid concentrations in newborn infants during parenteral nutrition
Insights
Parenteral nutrition with Vamin in critically ill newborns altered plasma amino acid levels, with many essential amino acids decreasing. This suggests a need for tailored amino acid formulations for infant parenteral nutrition.
Area of Science:
- Biochemistry
- Neonatology
- Nutritional Science
Background:
- Parenteral nutrition (PN) is crucial for critically ill newborns unable to feed enterally.
- Vamin is a common amino acid source used in PN, but its suitability for neonates requires evaluation.
- Plasma amino acid profiles can indicate nutritional status and metabolic responses in infants.
Purpose of the Study:
- To assess plasma amino acid concentrations in seriously ill newborn infants receiving total and partial parenteral nutrition with Vamin.
- To compare these concentrations against reference levels in healthy infants.
- To inform the development of optimized amino acid preparations for neonatal PN.
Main Methods:
- Measured plasma amino acid concentrations in 12 critically ill newborn infants undergoing PN with Vamin.
- Compared measured levels to established reference ranges for infants.
- Analyzed deviations from reference values for individual amino acids.
Main Results:
- Significant alterations in plasma amino acid concentrations were observed compared to reference infants.
- Eleven of 21 measured amino acids were low, including seven essential amino acids (Arg, Cys, Ile, Leu, Lys, Thr, Tyr).
- Seven amino acids were above the reference median, with three (Asp, Glu, Phe) showing exceptionally high levels.
Conclusions:
- Current Vamin-based PN regimens result in suboptimal plasma amino acid profiles in critically ill newborns.
- The observed deficiencies in essential amino acids highlight the need for adjusted formulations.
- Findings support the development of specialized amino acid solutions to meet neonatal nutritional requirements during PN.
Abstract:
Amino acid substance concentrations in plasma have been measured during total and partial parenteral nutrition with Vamin in 12 seriously ill newborn infants. When plasma amino acid concentrations were compared to the levels in reference infants, 11 of 21 were low, among the 11 were seven essential amino acids (Arg, Cys, Ile, Leu, Lys, Thr, Tyr), while concentrations above the reference median and range occurred for seven amino acids. For three (Asp, Glu, Phe) levels were exceptionally high. From these findings, from studies by others on amino acid levels during parenteral nutrition with Vamin, and from amino acid needs judged from venous-arterial differences in newborns, an amino acid preparation for parenteral administration to newborn infants is suggested.