Amino acid administration to premature infants directly after birth

Objectives: To test the hypothesis that the administration of 2.4 g amino acids (AA)/(kg·d) to very low birth weight infants is safe and results in a positive nitrogen balance. Study design: We conducted a randomized, clinical trial. Preterm infants with birth weights <1500 g received either glucose and 2.4 g AA/(kg·d) from birth onward (n = 66) or solely glucose during the first day with a stepwise increase in AA intake to 2.4 g AA/(kg·d) on day 3 (n = 69). Blood gas analysis was performed daily during the first 6 postnatal days; blood urea nitrogen levels were determined on days 2, 4, and 6; AA plasma concentrations and nitrogen balances were determined on days 2 and 4. Student t tests, Mann-Whitney tests, and χ² tests were performed to compare groups. Results: Infants supplemented with AA had no major adverse side effects. Their blood urea nitrogen levels were higher, nitrogen balance turned positive upon AA administration, and more AA concentrations were within reference ranges. Conclusions: High-dose AA administration to very low birth weight infants can be introduced safely from birth onward and results in an anabolic state.