TY - JOUR
T1 - Safety and efficacy of early parenteral lipid and high-dose amino Acid administration to very low birth weight infants
AU - Vlaardingerbroek, Hester
AU - Vermeulen, Marijn J.
AU - Rook, Denise
AU - van den Akker, Chris H. P.
AU - Dorst, Kristien
AU - Wattimena, Josias L.
AU - Vermes, Andras
AU - Schierbeek, Henk
AU - van Goudoever, Johannes B.
PY - 2013
Y1 - 2013
N2 - To assess the efficacy and safety of early parenteral lipid and high-dose amino acid (AA) administration from birth onwards in very low birth weight (VLBW, birth weight <1500 g) infants. VLBW infants (n = 144; birth weight 862 ± 218 g; gestational age 27.4 ± 2.2 weeks) were randomized to receive 2.4 g of AA kg(-1)·d(-1) (control group), or 2.4 g AA kg(-1)·d(-1) plus 2-3 g lipids kg(-1)·d(-1) (AA + lipid group), or 3.6 g AA kg(-1)·d(-1) plus 2-3 g lipids kg(-1)·d(-1) (high AA + lipid group) from birth onwards. The primary outcome was nitrogen balance. The secondary outcomes were biochemical variables, urea rate of appearance, growth rates, and clinical outcome. The nitrogen balance on day 2 was significantly greater in both intervention groups compared with the control group. Greater amounts of AA administration did not further improve nitrogen balance compared with standard AA dose plus lipids and was associated with high plasma urea concentrations and high rates of urea appearance. No differences in other biochemical variables, growth, or clinical outcomes were observed. In VLBW infants, the administration of parenteral AA combined with lipids from birth onwards improved conditions for anabolism and growth, as shown by improved nitrogen balance. Greater levels of AA administration did not further improve the nitrogen balance but led to increased AA oxidation. Early lipid initiation and high-dose AA were well tolerated
AB - To assess the efficacy and safety of early parenteral lipid and high-dose amino acid (AA) administration from birth onwards in very low birth weight (VLBW, birth weight <1500 g) infants. VLBW infants (n = 144; birth weight 862 ± 218 g; gestational age 27.4 ± 2.2 weeks) were randomized to receive 2.4 g of AA kg(-1)·d(-1) (control group), or 2.4 g AA kg(-1)·d(-1) plus 2-3 g lipids kg(-1)·d(-1) (AA + lipid group), or 3.6 g AA kg(-1)·d(-1) plus 2-3 g lipids kg(-1)·d(-1) (high AA + lipid group) from birth onwards. The primary outcome was nitrogen balance. The secondary outcomes were biochemical variables, urea rate of appearance, growth rates, and clinical outcome. The nitrogen balance on day 2 was significantly greater in both intervention groups compared with the control group. Greater amounts of AA administration did not further improve nitrogen balance compared with standard AA dose plus lipids and was associated with high plasma urea concentrations and high rates of urea appearance. No differences in other biochemical variables, growth, or clinical outcomes were observed. In VLBW infants, the administration of parenteral AA combined with lipids from birth onwards improved conditions for anabolism and growth, as shown by improved nitrogen balance. Greater levels of AA administration did not further improve the nitrogen balance but led to increased AA oxidation. Early lipid initiation and high-dose AA were well tolerated
U2 - https://doi.org/10.1016/j.jpeds.2013.03.059
DO - https://doi.org/10.1016/j.jpeds.2013.03.059
M3 - Article
C2 - 23660378
SN - 0022-3476
VL - 163
SP - 638-644.e5
JO - Journal of pediatrics
JF - Journal of pediatrics
IS - 3
ER -