Original ArticleSafety and Efficacy of Early Parenteral Lipid and High-Dose Amino Acid Administration to Very Low Birth Weight Infants
Section snippets
Methods
Between December 2008 and January 2012, we performed a randomized controlled trial at the NICU of the Erasmus MC–Sophia Children’s Hospital in Rotterdam, The Netherlands. The eligible patients were inborn VLBW infants (birth weight <1500 g) with a central venous catheter in place to allow for more concentrated glucose solutions and to restrict total fluid intake. Written informed consent was obtained from the infants’ parents before they were included. Exclusion criteria were congenital
Results
We included 144 VLBW infants: 48 in the control group, 49 in the AA + lipid group, and 47 in the high AA + lipid group (Figure 1; available at www.jpeds.com). Baseline characteristics are in Table I. Parenteral AA and lipid intake (Figure 2; available at www.jpeds.com) and total parenteral + enteral protein and energy intake (Table II; available at www.jpeds.com) were in agreement with the study protocol. Compared with the targeted intake of 3.6 g AA/day, the cumulative parenteral AA deficit on
Discussion
We demonstrated that 2-3 g of lipids kg−1·d−1 from birth onwards improved the nitrogen balance in VLBW infants compared with the initiation of lipids from the second day onwards, and a 50% greater AA intake (3.6 g·kg−1·d−1 vs 2.4 g·kg−1·d−1) did not further improve anabolism. The results of this study should be interpreted in the light of adjustments made to the parenteral nutritional intake. A total of 40%-80% of the infants required individual adjustments based on the urea and TG thresholds
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2022, Clinics in PerinatologyCitation Excerpt :An overview of recommended fat dosages is found in Table 1. The early initiation of IVFEs within the first 2 days of life is tolerated and may improve the nitrogen balance and improve growth in preterm infants.43,44 Early lipid administration may also support greater cerebellar volume by term-equivalent age in very preterm infants.45
The authors declare no conflicts of interest.
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