Introduction The beneficial effects of early nutrition in preterm infants are well known. Nonetheless, almost all VLBW infants (BW< 1500g) develop a protein and energy deficit in the first week of life. Consequently, protein balance is impaired. Lipids could aid in ameliorating the protein balance.
We hypothesized that early parenteral lipid and high dose amino acid (AA) administration from birth onwards to VLBW infants is safe and results in a higher protein balance.
Methods Inborn VLBW infants were randomized to one of three different parenteral nutritional regimens (Figure).
Nitrogen (N) balances and urea rate of appearance ([urea]Ra, subgroup of infants) were measured at day two; biochemistry was recorded daily.
Results Table shows significant differences at day 2.
Blood gas, platelet count, electrolytes, and bilirubin were not significantly different between groups.
Conclusion Introduction of 2g lipids/(kg.d) and 3.6g AA/(kg.d) from birth onwards seems safe and results in a higher N-balance and thus increased anabolism in VLBW infants. Urea is more likely a marker of AA metabolism than of AA intolerance.