Effect of Two Different Doses of Parenteral Amino Acid Supplementation on Postnatal Growth of Very Low Birth Weight Neonates – A Randomized Controlled Trial.
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Date
2013-12
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Abstract
Objectives: To evaluate the effects of two different doses of
parenteral aminoacid supplementation on postnatal growth in
Very Low Birth Weight (VLBW) infants receiving partial parenteral
nutrition (PPN).
Design: Double blinded randomized controlled trial.
Settings: Level 3 NICU between February 2008 to February
2010.
Participants: 150 inborn babies with birthweight between 900-
1250 g, irrespective of gestational age, were randomized to either
of the two interventions of amino acid supplementation.
Intervention: Two different initial doses of parenteral amino acids
(AA) in the PPN solutions- Low AA group: 1 g/kg/d versus High AA
group: 3 g/kg/d from day 1 of life with increment by 1 g/kg every
day till a maximum of 4 g/kg/d, until babies tolerated 75% enteral
feeds.
Main outcome: Average postnatal weight gain (in g/kg/d)) by 28
days of life.
Results: Both groups had similar baseline characteristics. The
gain in weight, length and head circumference at 28 days were
significantly lower in the High AA group. The average weight gain
at 28 days was 8.67g/kg/d in the High AA group and 13.15g/kg/d
in the Low AA group (mean difference 123.12, 95% CI 46.67 to
199.37, P<0.001). The incidences of neonatal morbidities
associated with prematurity were similar in both groups.
Conclusion: Higher initial parenteral aminoacid supplementation,
in settings where partial parenteral nutrition is
administered, results in poor growth in VLBW infants due to
inadequate non-protein calorie intake.
Description
Keywords
Amino acid, Postnatal growth, Very low birth weight
Citation
Balasubramanian Haribalakrishna, Nanavati Ruchi N, Kabra Nandkishor S. Effect of Two Different Doses of Parenteral Amino Acid Supplementation on Postnatal Growth of Very Low Birth Weight Neonates – A Randomized Controlled Trial. Indian Pediatrics. 2013 December; 50(12): 1131-1136.