Bibliographic Details
| Title: |
Ratio of non-protein calories to grams of amino acids and amino acid blood levels in preterm infants receiving parenteral nutrition. |
| Authors: |
Huston, Robert K1,2 (AUTHOR) rkneoart@aol.com, Clark, Reese H2 (AUTHOR), Chace, Donald H3 (AUTHOR) |
| Source: |
Journal of Neonatal - Perinatal Medicine. Mar2025, Vol. 18 Issue 2, p126-136. 11p. |
| Subject Terms: |
*PREMATURE infants, *BLOOD urea nitrogen, *AMINO acids, *PARENTERAL solutions, *PARENTERAL feeding |
| Abstract: |
Background: Studies evaluating the optimal intake of amino acids for preterm infants have often not considered the effect of the non-protein calorie to grams of amino acids ratio (NPKcal:g AA) in parenteral nutrition solutions. The objectives of this study were to document the ratio in a group of preterm infants and explore any associations of the ratio to AA and acylcarnitine levels. Methods: This was descriptive cohort study of data collected from a previously published prospective study evaluating the influence that gestational age had on amino acid and acylcarnitine profiles in preterm infants ≤31 weeks postmenstrual age. Acylcarnitine and AA levels on day of life 7 of three study groups, based upon terciles of the NPKcal:g AA, who were receiving minimal enteral feedings and an enterally fed comparison group were measured. Growth velocities and changes in z-scores were also evaluated. Results: NPKcal:g AA terciles were: 6.3–17.6:1 (low, N = 153), 17.7–21.2:1 (mid, N = 150), and 21.3–36.2:1 (high, N = 159). Higher levels of ornithine, citrulline, blood urea nitrogen, isovalerylcarnitine + methylbutyrylcarnitine, and octenoylcarnitine were found in the low versus the high group. From day 1–42 of life, the low group had a lower head circumference (HC) growth velocity and the low and mid groups had more negative HC changes in z-scores versus the enteral group. Conclusions: This study suggests that preterm infants may receive parenteral nutrition solutions containing inadequate energy to prevent oxidation of administered AA. The impact of inadequate non-protein caloric intake needs to be considered when evaluating growth and outcomes in nutritional studies of VLBW infants. [ABSTRACT FROM AUTHOR] |
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