687 Survey of scope of services provided by paediatricians with interest in paediatric gastroenterology across England

Abstract

days of PN. The intervention and comparator are low versus high parenteral leucine intakes expressed as either the percentage leucine content of the AA solution (%) or absolute leucine intake (mg/kg/d). The outcome measured was plasma leucine concentration (micromoles/L). All study designs were eligible for inclusion, except for review articles. Only articles which reported the actual parenteral AA intake and measured plasma leucine concentration after day 3 (72 hours) of PN were eligible. The data were obtained using a data extraction form designed for this review. Quality assessments using a custom-designed tool and the GRADE framework were performed.Results Twelve articles met the inclusion criteria, which collectively studied 650 VPNs. The dose-concentration relationships of leucine content (%) and absolute leucine intake (g/kg/d) with plasma leucine concentration (micromoles/L) both showed significant, moderately positive correlations (p < 0.05), as shown in figure 1. Regression analysis indicated that absolute leucine intake was the stronger predictor of outcome. Subgroup analysis indicated that neither the overall study design nor the analytical method used for AA analysis affected the plasma leucine level. Abstract 782 Figure 1 Dose concentration relationship graph of absolute leucine intake with plasma leucine concentration Abstract 782 Figure 2 Dose concentration relationship graph of percentage leucine content with plasma leucine concentrationConclusion There is a linear relationship between plasma leucine concentration and both percentage leucine content and leucine intake (mg/kg/day) in VPNs. This work indicates that the leucine content of future neonatal PN solutions should be reduced to 8-9g/100g AA to achieve plasma AA concentrations within the reference range. This methodology can be applied to all essential AA.