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Clinical outcome as assessed by anthropometric parameters, albumin, and cellular immune function in high-risk infants
Insights
Higher calorie intake in infants receiving total parenteral nutrition (TPN) promotes catch-up growth and improves body composition. Immune function and serum albumin levels were not significantly affected by calorie intake in this study.
Area of Science:
- Pediatric Nutrition
- Gastroenterology
- Clinical Research
Background:
- Infants with gastrointestinal disorders often require nutritional support.
- Total parenteral nutrition (TPN) is a critical intervention for these patients.
- Optimizing TPN delivery is essential for promoting growth and development.
Purpose of the Study:
- To evaluate the impact of calorie intake from TPN on growth and immune parameters in infants.
- To determine the optimal calorie threshold for catch-up growth in this population.
Main Methods:
- Retrospective study of 12 infants receiving 16 courses of TPN.
- Stratification of infants based on daily calorie intake (110 calories/kg/d threshold).
- Assessment of anthropometric measurements (weight, mid-arm muscle circumference, skinfold thicknesses) and in vitro cellular immune parameters.
Main Results:
- Infants receiving >110 calories/kg/d showed significantly greater increases in weight and body composition compared to those receiving <110 calories/kg/d.
- Catch-up growth was exclusively observed in the higher calorie intake group (>110 calories/kg/d).
- No significant differences in immune parameters (PWM, PHA responses, T lymphocyte percentage) or serum albumin levels were noted between groups.
Conclusions:
- Calorie intake significantly influences growth outcomes in infants receiving TPN.
- A threshold of >110 calories/kg/d appears necessary for achieving catch-up growth.
- While promoting growth, TPN at this level did not substantially alter cellular immune responses or serum albumin levels.
Abstract:
Twelve infants with underlying gastrointestinal tract disorders receiving 16 courses of total parenteral nutrition were retrospectively studied. Stratification according to calorie intake provided the best means for discriminating among different outcomes. Infants receiving greater than 110 calories/kg/d experienced significantly greater increases in weight, mid-arm muscle circumference, and triceps and subscapular skinfold thicknesses than did infants receiving less than 110 calories/kg/d. Catch-up growth was only seen in infants with intakes of greater than 110 calories/kg/d. In nine of these 12 infants, in vitro cellular immune parameters were assayed. Infants in both the high- and low-calorie groups experienced similar increases in transformational responses to pokeweed mitogen (PWM) and phytohemagglutinin (PHA) and in the percentage of peripheral blood T lymphocytes. No increase in serum albumin was seen regardless of calorie intake.