INTRAVENOUS NUTRITION AND POSTNATAL GROWTH OF THE MICROPREMIE
Section snippets
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
References (122)
- et al.
A controlled trial of glucose versus glucose and amino acids in premature infants
J Pediatr
(1979) - et al.
Effect of intrauterine growth retardation on postnatal weight change in preterm infants
J Pediatr
(1993) - et al.
Energy expenditure and severity of respiratory disease in very low birth weight infants receiving long-term ventilatory support
J Pediatr
(1992) - et al.
Insulin infusion with parenteral nutrition in extremely low birth weight infants with hyperglycemia
J Pediatr
(1989) - et al.
Protein-metabolism kinetics and energy-substrate utilization in infants fed parenteral solutions with different glucose-fat ratios
Am J Clin Nutr
(1991) - et al.
A controlled trial of insulin infusion and parenteral nutrition in extremely low birth weight infants with glucose intolerance
J Pediatr
(1991) - et al.
Soybean oil emulsion administration during parenteral nutrition in the preterm infant: Effect on essential fatty acid, lipid, and glucose metabolism
J Pediatr
(1987) - et al.
Pulmonary arterial lipid deposit in newborn infants receiving intravenous lipid infusion
J Pediatr
(1980) - et al.
A grid for recording the weight of premature infants
J Pediatr
(1948) - et al.
Early metabolic effects of sepsis in the preterm infant: Lactic acidosis and increased glucose requirement
J Pediatr
(1992)
The modifying influence of anaesthesia on postoperative protein catabolism
Br J Anaesth
Late effects of early dietary protein intake on low-birth-weight infants
J Pediatr
Plasma lipid and plasma lipoprotein concentrations in low birth weight infants given parenteral nutrition with twenty or ten percent lipid emulsion
J Pediatr
Intravascular fat accumulation after Intralipid infusion in the very low-birth-weight infant
J Pediatr
Glucose utilization in the surgical newborn infant receiving total parenteral nutrition
J Pediatr Surg
Pulmonary fat accumulation after Intralipid infusion in the preterm infant
Lancet
Effect of Intralipid on the neonatal pulmonary bed: An echographic study
J Pediatr
Breast milk and subsequent intelligence quotient in children born preterm
Lancet
Energy expenditure in children with congenital heart disease, before and after cardiac surgery
J Thorac Cardiovasc Surg
Oxidation of parenteral lipid emulsion by ambient and phototherapy lights: Potential toxicity of routine parenteral feeding
J Pediatr
Total-body protein turnover in parenterally fed neonates: Effects of energy source studied by using [15N]glycine and [1-13C]leucine
Am J Clin Nutr
Metabolism of intravenous fat emulsion in the surgical newborn
J Pediatr Surg
Total parenteral nutrition in the newborn: Impact of the quality of infused energy on nitrogen metabolism
Am J Clin Nutr
Exogenous insulin reduces proteolysis and protein synthesis in extremely low birth weight infants
J Pediatr
Quantitative effect of isoenergetic exchange of fat for carbohydrate on dietary protein utilization in healthy young men
Am J Clin Nutr
Energy metabolism, substrate utilization, and nitrogen balance in parenterally fed postoperative neonates and infants
J Pediatr
Physiologic programming of the fetus
Clin Perinatol
Effect of heparin dose and infusion rate on lipid clearance and bilirubin binding in premature infants receiving intravenous fat emulsions
J Pediatr
Intravenous administration of lipid emulsions to premature infants
Clin Perinatol
Nutritional needs of low-birth-weight infants
Pediatrics
Fetal nutrition
Annu Rev Nutr
An Introduction to Fetal Physiology
Factors associated with growth of extremely premature infants during initial hospitalization
Pediatrics
Carnitine
Annu Rev Nutr
Tolerance of fat emulsions in very-low-birth-weight neonates
Am J Dis Child
Influence of intravenous fat emulsion on serum bilirubin in very low birthweight neonates
Arch Dis Child
Energy substrate utilization in infants receiving total parenteral nutrition with different glucose to fat ratios
Pediatr Res
Catabolic effect of dexamethasone in the preterm baby
Arch Dis Child
Nutrient intakes and growth of very low birth weight infants
J Perinatol
Energy-nitrogen balances and protein turnover in small and appropriate for gestational age low birthweight infants
Eur J Clin Nutr
Survey: Methods of feeding low-birth-weight infants
Pediatrics
Safflower oil emulsion administration during parenteral nutrition in the preterm infant. 1. Effect on essential fatty acid status
J Pediatr Gastroenterol Nutr
Water as nutrition
Regulation of amino acid metabolism by epinephrine
Am J Physiol
Nutrition and metabolism in the high-risk neonate
Effect of intravenous glucose and lipid on proteolysis and glucose production in normal newborns
Am J Physiol
The effect of varying protein quality and energy intake on the nitrogen metabolism of parenterally fed very low birthweight (<1600 g) infants
Pediatr Res
Glucose intolerance in infants of very low birth weight. I. Incidence of hyperglycemia in infants of birth weight 1,100 grams or less
Pediatrics
Uptake and asymmetric efflux of amino acids at maternal and fetal sides of placenta
Am J Physiol
Effect of early introduction of formula versus fat free parenteral nutrition on essential fatty acid status of preterm infants
Am J Clin Nutr
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.