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356 Albumin Synthesis Rates in VLBW Infants - Effects of High dose Amino Acid and Lipid Administration from Birth Onwards
  1. H Vlaardingerbroek1,
  2. D Rook1,
  3. H Schierbeek1,2,
  4. CHP van den Akker3,
  5. MJ Vermeulen1,
  6. JB van Goudoever2,4
  1. 1Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children’s Hospital, Rotterdam
  2. 2Pediatrics, Academic Medical Center - Emma Children’s Hospital, Amsterdam
  3. 3Pediatrics, Erasmus MC - Sophia Children’s Hospital, Rotterdam
  4. 4Pediatrics, VU University Medical Center, Amsterdam, The Netherlands

Abstract

Introduction Albumin is one of the most important proteins in plasma and plays a key role in physiological processes like preservation of colloid osmotic pressure and binding of bilirubin and drugs. However, albumin concentrations are often low during the first days of life in preterm infants.

We hypothesized that early parenteral lipid and high dose amino acid (AA) administration from birth onwards to very low birth weight (VLBW) infants increases hepatic albumin synthesis rates and albumin concentration.

Methods Inborn VLBW infants were randomized to one of three different parenteral nutritional regimens within 6hrs after birth (Figure 1). Lipids were started at 2 g/(kg.d) and increased to 3 g/(kg.d) the following day.

Abstract 356 Figure 1

Study design

At postnatal day 2, infants received a primed continuous infusion of [13C6,15N]leucine. Mass spectrometry was used to determine the fractional and absolute albumin synthesis rates (FSR and ASR, respectively).

Results Albumin FSR, concentration, and ASR were not significantly different between groups (Figure 2; median, IQR).

Abstract 356 Figure 2

Albumin FSR, concentration, and ASR

Conclusion Albumin concentration was in normal range in all groups. Albumin synthesis rates and concentration are not increased upon introduction of 2g lipids/(kg.d) and 3.6g AA/(kg.d) from birth onwards.

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