A controlled trial of glucose versus glucose and amino acids in premature infants

Anderson, Thomas L.; Muttart, Catherine R.; Bieber, Mark A.; Nicholson, John F.; Heird, William C.

doi:10.1016/s0022-3476(79)80230-9

Cited by 120 publications

(49 citation statements)

References 10 publications

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“…administration of similar amounts of amino acids (1.5 g. k g -' . d l ) to ill preterm infants has been shown previously (4,5) to result in positive nitrogen balance despite inadequate energy intake. Our demonstration of positive nitrogen balance in infants infused with amino acids should be interpreted with caution because of the short period of study and the low nonprotein energy intake (6.…”

Section: Discussionmentioning

confidence: 92%

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Effect of Intravenous Amino Acids on Protein Metabolism of Preterm Infants during the First Three Days of Life

1993

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Section: Discussionmentioning

confidence: 92%

“…Utilization of intravenously infused amino acids has been studied in older and more stable infants by nitrogen balance (4,5). However, interpretation of data obtained by the nitrogen balance technique is limited by errors inherent to the method (6).…”

mentioning

confidence: 99%

Effect of Intravenous Amino Acids on Protein Metabolism of Preterm Infants during the First Three Days of Life

1993

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“…Infants were enrolled in isotope studies if parents consented to blood sampling and if endotracheal tube air leak was Ͻ5% to ensure accurate carbon dioxide production measurements. Infants were administered a priming dose of [1][2][3][4][5][6][7][8][9][10][11][12][13] C]leucine (1.0 mg/kg ϭ 7.6 mol/kg) and [6,6-2H2] ). All isotopes were obtained from Cambridge Isotope Laboratories (Woburn, MA, U.S.A.).…”

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confidence: 99%

Effect of Low versus High Intravenous Amino Acid Intake on Very Low Birth Weight Infants in the Early Neonatal Period

Thureen

2003

Pediatric Research

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Greater protein intakes are required than have been commonly used to achieve fetal in utero protein accretion rates in preterm neonates. To study the efficacy and safety of more aggressive amino acid intake, we performed a prospective randomized study in 28 infants [mean wt, 946 Ϯ 40 g (SEM)] of 1 (low amino acid intake, LAA) versus 3 g·kg Ϫ1 ·d Ϫ1 (high amino acid intake, HAA) at 52.0 Ϯ 3.0 h of life. After a minimum of 12 h of parenteral nutrition, efficacy was determined by protein balance and was significantly lower in the LAA versus HAA groups by both nitrogen balance (Ϫ0. Abbreviations PN, parenteral nutrition LAA, low amino acid intake HAA, high amino acid intake Int leuc , leucine intake rate Q leuc , leucine flux rate Ox leuc , leucine oxidation rate NOD leuc , nonoxidative leucine disposal intake rate RP leuc , rate of leucine appearance from protein breakdown ELBW, extremely low birth weight BUN, blood urea nitrogen GCMS, gas chromatography-mass spectroscopyThe current standard for postnatal nutrition in all preterm infants is one that duplicates normal in utero fetal growth rates (1). Owing to advances in perinatal care, more very preterm infants are surviving. These infants have unique nutritional metabolic requirements for growth, predicted by low energy stores, high protein flux rate, and a high metabolic rate as a result of a relatively larger mass of metabolically active organs. Nevertheless, it is common practice in many neonatal intensive care units to limit nutrient administration, particularly amino acids, to ELBW or sick neonates in the early neonatal period because of concerns of substrate intolerance. Several studies suggest that this delay in nutrition results in postnatal malnutrition that produces measurable growth failure at hospital discharge (2-4).Although strategies to improve growth necessitate delivery of larger amounts of both energy and protein beginning shortly after birth, there are reasons to suggest that focusing on protein delivery may be particularly important. Throughout life, maximal weight-specific protein gain occurs before 32 wk gestation (5). Data from studies in fetal animal models suggest that amino acid metabolic rates may be a much more sensitive indicator than growth rate of adequate nutrition before term (6). Additionally, recent data suggest that long-term developmental outcome in the preterm may be correlated with early protein intake (7

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“…All infants in the HAA group reached full enteral feeding by the eighth day, which was much faster than the rate reported in previous studies. It has been reported that VLBW infants require a daily minimum of 60 kcal/kg/d (including 2.5 g/kg/d of AA) to minimize catabolism, and 80 to 90 kcal/kg/d (including 2.7 to 3.5 g/kg/d of AA) to maintain the rate of growth [13,14]. Preterm infants should receive nutrition similar to that in their intrauterine life.…”

Section: Discussionmentioning

confidence: 99%

Effect of Aggressive Early High-Dose Intravenous Amino Acid Infusion and Early Trophic Enteral Nutrition on Very Low Birth Weight Infants

Ho¹,

Yen²,

Chen³

et al. 2012

FNS

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Objective: Very-low-birth-weight (VLBW) preterm infants are at risk of growth delay if they do not receive adequate nutritional support. This study evaluated the effect of aggressive early high-dose amino acid infusion plus early enteral trophic feeding on growth in VLBW infants within the first day of life. Study Design: The effect of a high-dose 3 g amino acid (HAA)/kg/d regimen beginning on the first day of life was compared with that of low-dose amino acid (LAA) supplementation at a dose of 0.5 or 1.0 g/kg/d. The primary outcome measures were the days of regained birth weight and achieved full enteral feeding. Result: Compared with the 19 infants in the LAA group, the 17 infants in the HAA group achieved significantly earlier full enteral feeding (7.8 ± 3.6 vs. 15.2 ± 8.9, p = 0.003) and regained birth weight (13.3 ± 3.8 vs. 17.5 ± 7.9, p = 0.047). In addition, shorter parenteral nutrition time was achieved by HAA administration (p < 0.05). Total energy intake was greater during the first 7 days of life in the HAA group (85 ± 12 kcal/kg/d on day 7) than in the LAA group (60 ± 16 kcal/kg/d on day 7, p < 0.001). Other clinical parameters such as length of hospital stay and morbidity favored the use of HAA. Conclusion: Aggressive early simultaneous amino acid administration plus enteral feeding during the first few days of life for preterm infants was associated with improved weight gain and earlier full enteral feeding.

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A controlled trial of glucose versus glucose and amino acids in premature infants

Cited by 120 publications

References 10 publications

Effect of Intravenous Amino Acids on Protein Metabolism of Preterm Infants during the First Three Days of Life

Effect of Intravenous Amino Acids on Protein Metabolism of Preterm Infants during the First Three Days of Life

Effect of Low versus High Intravenous Amino Acid Intake on Very Low Birth Weight Infants in the Early Neonatal Period

Effect of Aggressive Early High-Dose Intravenous Amino Acid Infusion and Early Trophic Enteral Nutrition on Very Low Birth Weight Infants

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