title: [Stress adapted parenteral amino acid substitution in operated premature and newborn infants].
abstract: Parenteral nutrition contributes considerably to the survival of operated newborns. The postoperative period, however, gives rise to special metabolic problems. Commercially available L-amino acid (L-AA) solutions may lead to imbalances in the postoperative period. We used a preparation containing all essential and non essential L-AA, which should take the stress metabolism into account. Twenty newborn infants were treated with a standardized parenteral nutrition regime after major surgery. Two comparable groups were formed; the first (A) receiving up to 2 g L-AA/kg/day and the second (B) 1.5 g L-AA/kg/day at the most. On the seventh postoperative day group B was loaded with 1 g L-AA/kg within 6 h corresponding to the transfer rate in healthy newborn infants calculated by Bürger and Wolf. Plasma L-AA were checked on the seventh day before and after loading. The serum L-AA showed almost normal values in group A, however, several values were found to be too low in group B (proline, alanine, cystine, leucine). After the L-AA load some increased above normal levels (threonine, glycine, lysine, histidine). With reference to these results a daily application of 1.5-2.0 g of L-AA/kg can be recommended for critically ill newborns in the early postoperative period.
authors.affiliation: Universitätsklinik für Kinderchirurgie Graz.
authors.forename: P H
authors.initials: PH
authors.lastname: Schober
authors.forename: R
authors.initials: R
authors.lastname: Kurz
authors.forename: H E
authors.initials: HE
authors.lastname: Musil
authors.forename: E
authors.initials: E
authors.lastname: Jarosch
mesh_terms: D000596:Amino Acids / Q000008:administration & dosage* / Q000097:blood; D000641:Ammonia / Q000097:blood; D001724:Birth Weight; D001798:Blood Proteins / Q000378:metabolism; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D005865:Gestational Age; D005919:Glomerular Filtration Rate; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000601:surgery*; D009751:Nutritional Requirements; D010289:Parenteral Nutrition, Total / Q000379:methods*; D011183:Postoperative Complications / Q000097:blood / Q000628:therapy*; D013312:Stress, Physiological / Q000628:therapy*
chemical_list: D000596:Amino Acids; D001798:Blood Proteins; D000641:Ammonia; D003404:Creatinine
vernacular_title: Stressadaptierte parenterale Aminosäurensubstitution bei operierten Früh- und Neugeborenen.