None listed
Conditions
Brief summary
The preterm infant misses the last trimester of fetal nutrient accretion and requirement for immediate nutrient delivery that included amino acids may be essential due to limited glycogen and fat reserves. Significant nutrient deficiencies are observed in the neonatal intensive care unit and premature infants are frequently discharged at weights less than the 10th percentile. Perhaps more concerning than low discharge weights is the association of poor growth in the early weeks of hospitalization with abnormal neurodevelopment and an increased prevalence of cerebral palsy. The goal of early amino-acid supplementation is to provide the preterm infant with intravenous substrate that promotes protein deposition and increased lean body mass that more closely approximates fetal energy production and growth. Several previous investigations have demonstrated the beneficial effect of early parenteral amino acids on decreasing protein loss in preterm infants However, despite aggressive nutrition with high intakes of amino acids in the first hours of life, for some essential aminoacids it is impossible to reach in very low birth weight (VLBW) infants levels similar to those observed in human fetus during the second and third trimesters of pregnancy. We presumed that the lower concentrations of essential amminoacids limited protein accretion and growing performance of VLBW infants. We would like to see the effect of administration of essential amino acids on the growth of VLBW infants
Interventions
supplementation with essential aminoacids in addition to enteral and parenteral nutrition
The aminoacids administered were the following:
L- Istidina
L- Isoleucina
L- Leucina
L- Lisina
L- Metionina
L- Fenilalanina
L- Treonina
L- Triptofano
L- Valina
The formulation was on opened capsule containing dispersible powder that was added to the milk
The amount of aminoacids provided through enteral and parenteral nutrition, regardless of supplementation with essential amino acids, were the followin
supplementation with essential aminoacids in addition to enteral and parenteral nutrition The aminoacids administered were the following: L- Istidina L- Isoleucina L- Leucina L- Lisina L- Metionina L- Fenilalanina L- Treonina L- Triptofano L- Valina The formulation was on opened capsule containing dispersible powder that was added to the milk The amount of aminoacids provided through enteral and parenteral nutrition, regardless of supplementation with essential amino acids, were the following: Starting amminoacids intakes: 1.5 gr/kg Daily increase: 0.5 gr/kg once a day Total intakes of amminoacids (enteral and parenteral nutrition) nearly to 10 days of life: 3.5-4.0 gr/kg The essential amminoacids, available as pharmaceutical formulation in capsule form, were delivered with the following schedule, taking into account the weight: 500-1000 gr: 1 gr/kg/once a day 1001-1500 gr: 0.8 gr/kg/once a day 1501 – 2000 gr: 0.5 gr/kg/once a day Supplementation started on the recruitment, in the first 24 hours of life, and was ceased at discharge
Sponsors
Osp. Buon Consiglio
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
1 Hours to 3 Hours
Healthy volunteers
Yes
Inclusion criteria
birth weight < 1500 gr obtaining informed consent from parents
Exclusion criteria
major congenital abnormality including known chromosomal abnormality twin-twin transfusion intra-uterine transfusion or exchange transfusion Rhesus iso-immunisation significant multi-organ failure prior to trial entry
Outcome results
None listed