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Plasma amino acid patterns during supplemental intravenous nutrition of low-birth-weight infants
Insights
Intravenous nutrition supplement (INS) improved weight gain in low-birth-weight (LBW) infants compared to conventional feedings. While mortality rates were similar, INS-fed infants who did not survive lived longer, though hyperglycemia was more frequent.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Biochemistry
Background:
- Low-birth-weight (LBW) infants often exhibit altered plasma amino acid profiles at birth.
- Understanding these profiles is crucial for optimizing nutritional support in vulnerable newborns.
Purpose of the Study:
- To compare the effects of intravenous nutrition supplement (INS) versus conventional feedings in LBW infants.
- To analyze growth, morbidity, mortality, and plasma amino acid patterns.
- To provide recommendations for improved INS solutions for LBW infants.
Main Methods:
- A comparative study involving 42 LBW infants (<1,200 gm).
- Assessment of weight gain, complications (including hyperglycemia), and mortality.
- Analysis of plasma amino acid patterns (aminogram) and comparison with full-term infants and adults.
Main Results:
- LBW infants showed hypoaminoacidemia at birth, with significantly lower levels of glutamine, alanine, glycine, histidine, and ornithine compared to full-term infants.
- Despite similar caloric intake, INS infants exhibited greater weight gain than control infants.
- Nonsurviving INS infants lived longer (30 days) than nonsurviving control infants (5 days).
- Hyperglycemia was more frequent in the INS group; glutamine remained subnormal even with INS.
Conclusions:
- INS can enhance weight gain in LBW infants and prolong survival in nonsurvivors.
- Current INS formulations may require adjustments, particularly regarding glutamine levels.
- Further research is needed to optimize INS for LBW infants to address specific amino acid deficiencies and metabolic complications like hyperglycemia.
Abstract:
In 42 low-birth-weight infants (smaller than 1,200 gm), we have compared the effects of intravenous nutrition supplement versus conventional feedings on growth, morbidity, mortality, and plasma amino acid patterns. Despite similar total caloric intake in INS and control groups, weight gain was greater in the INS infants. The overall mortality rate did not differ in the two groups. Nonsurviving infants receiving INS lived longer (mean equal to 30 days) than nonsurviving CON infants (mean equal to 5 days). Complications were equally frequent in both groups except that hyperglycemia occurred more often in infants receiving INS. The plasma aminogram of the LBW infant is described and compared to those of the full-term infant and adult. Hypoaminoacidemia was present at birth in the LBW infants, concentrations of glutamine, alamine, glycine, histidine, and ornithine being significantly (P smaller than 0.05) below FT values. During INS, elevations of threonine, serine, and methionine above FT values occurred. Glutamine remained subnormal despite INS. Recommendations for an INS solution more suitable for use in LBW infants are presented.