Elsevier

Clinics in Perinatology

Volume 27, Issue 1, 1 March 2000, Pages 197-219
Clinics in Perinatology

INTRAVENOUS NUTRITION AND POSTNATAL GROWTH OF THE MICROPREMIE

https://doi.org/10.1016/S0095-5108(05)70014-2Get rights and content

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Amino Acids.

The current gold standard for growth in neonates is to mimic in utero weight gain. Net protein gain, or protein accretion, however, is a much more appropriate indicator of nutritional status than weight gain alone. Protein accretion implies true growth, whereas increases in mass may reflect nothing more than water retention, particularly in ELBW infants in the first weeks of life. Maximal weight-specific protein gain throughout life occurs prior to 32 weeks gestation.64 Infants who receive only

SELECTED QUESTIONS TO BE ANSWERED REGARDING TPN IN ELBW INFANTS

In order to optimize intravenous protein delivery there needs to be a better understanding of which amino acids should be considered conditionally essential in ELBW infants, and under which clinical circumstances additional amino acids might be placed in this category. This designation implies that endogenous production of these amino acids might not be adequate and the infant is dependent on exogenous delivery to meet metabolic demands. Cysteine, taurine, tyrosine, histidine, arginine, and

POSTNATAL GROWTH

Nutritional strategies in ELBW are aimed at achieving in utero fetal growth rates. The success of these regimens is generally assessed by plotting infant growth on one of the many available growth curve charts.23, 59 Normal fetal growth rates generally have been derived from cross-sectional data on anthropometric measurements obtained in infants born at different gestational ages. Criticisms of these growth curves include that they reflect static, one-time data points and not sequential growth

SUMMARY

There is a growing body of evidence that early nutritional practices may affect short-term growth and developmental outcome.39, 61, 87 In addition, they may play a role in determining adult health and disease.38, 41, 60, 93 There is much that needs to be learned about safe and efficacious nutrient administration in the ELBW population; about techniques to assess the effect of different nutritional strategies; and about the long-term effects of these regimen or development outcome, growth, and

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  • Cited by (0)

    Address reprint requests toPatti J. Thureen, MD, Department of Pediatrics, Section of Neonatology, B-195, University of Colorado Health Sciences Center, 4200 E 9th Avenue, Denver, CO 80262, e-mail: [email protected]

    This work was supported by Grant No. NIH GCRG Grant M01RR00069 from the National Institutes of Health.

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