THE METABOLIC TOLERANCE OF INTRAVENOUS AMINO ACIDS IN PRETERM INFANTS IN THE FIRST WEEK OF LIFE

42 infants gestation <32 weeks (28.6±2.16.M±SD) received supplementary parenteral nutrition. Birthweight 1099±388g (M±SD) (19 <1kg). 37 infants were ventilated on day 1 and 29 on day 6. Dextrose, electrolytes, amino acids and lipids were given to supplement expressed breast milk or formula. The total nitrogen intake and proportion provided by the amino acids were 0.09 (range 0.01-0.38)g/kg/d (65%) on day 1 and 0.3 (range 0.07c 0.48)g/kg/d (66%) on day 6. The total calorie: nitrogen ratio on day 1 was 847 and this decreased to 264 on day 6. The reduction of body weight during the 6 days was 6%. Plasma albumin increased 11% from 22.4±6.4 (M±SD)g/L to 25.0±5.0g/L (p<0.05). Daily plasma, electrolytes, glucose, urea were all normal but the mean plasma phosphate fell to less than 1mmol/L on days 4-6. The mean plasma alkaline phosphatase of 209±87 (M±SD)IU/L on day 1 rose to 270±115IU/L by day 5 (p<0.01). The total bilirubin rose from 99.7±52 (M±SD)umoles/L on day 1 to peak at 130±49umoles on day 4 to fall to 104±55umoles/L on day 6. This was thought to represent ‘normal’ preterm hyperbilirubinaemia. Overall the metabolic tolerance of the preparation in these immature and sick infants was excellent.