Amino acid administration to premature infants directly after birth.
OBJECTIVE
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.


METHODS
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 chi2 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.
te Braake
Frans W J
FW
Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.
van den Akker
Chris H P
CH
Wattimena
Darcos J L
DJ
Huijmans
Jan G M
JG
van Goudoever
Johannes B
JB
D000596:Amino Acids / Q000008:administration & dosage* / Q000097:blood; D001806:Blood Urea Nitrogen; D002657:Child Development / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development* / Q000378:metabolism*; D019102:Infant, Very Low Birth Weight / Q000254:growth & development* / Q000378:metabolism*; D008297:Male; D009584:Nitrogen / Q000378:metabolism*; D010288:Parenteral Nutrition; D016037:Single-Blind Method
D000596:Amino Acids; D009584:Nitrogen