[Investigations on the utilization of parenterally administered amino acids in premature and small-for-dates neonates. IV. Control of the amino acid blood level during infusion of a pharmacokinetically balanced amino acid solution (author's transl)]

Plasma amino acids in supplementary parenteral nutrition of preterm infants. Effect of different quantities of amino acid infusion and comparison with enteral feeding

The present investigation aims to determine quantity and quality of the amino acid (AA) solution to be used in supplementary parenteral nutrition (SPN). We established the plasma AA concentrations of preterm infants (birthweight 1160-1940 g, mean 1540; gestational age 29-30 weeks, mean 32) divided into three groups. Group I (n = 11) and group II (n = 12) were put on a standardised SPN regimen starting with an intravenous supply of 2.5 resp. 1.5 g AA/kg/day. Infants of group III were formula-fed, and served as controls. A total of 231 aminograms was obtained during the first two weeks of age. Comparison of groups I and II to group III revealed plasma accumulation of six AA in group I. Supplementation in group II resulted in a normal pattern, except alanine, proline, and methionine. However, only deviations of proline and methionine may be judged as imbalances, and lowering in composition may be considered. We conclude that the low intravenous AA intake employed in group II may be preferred in SPN of preterm infants.

Total parenteral nutrition in pediatrics

Parenteral nutrition (p.N.) is indicated whenever oral food intake is partly or completely disturbed. The objective of this type of treatments is to provide the organism with sufficient nutrients and maintain the structure and growth. The supply of an optimum mixture of water, protein, carbohydrates, fats, minerals, vitamins and trace elements is a prerequisite for this. In the following parts of this study the indications for p.N., the technique and requirements for different nutrients, minerals, trace elements and vitamins are presented. A type of amino acid mixture especially prepared for pediatric use is prevented and new results of t.p.N. are discussed. In the following parts of this study the indications for p.N., the technique and practice of the infusion programme, the clinical and laboratory investigation of t.p.N., the complications and their prophylaxis during the p.N. are discussed. The goal of better total parenteral nutrition is approached when dosage, infusion rate, contraindications and the guidelines discussed here are observed. We will, however, continue the work for a further improvement of intravenous nutrition.