Background and Aims Early administration of parenteral amino acids (AA) has been shown to limit catabolism and improve growth in extremely low birth weight (ELBW) infants. This study aimed to evaluate an earlier, more aggressive administration of amino acids, was safe and well-tolerated, without clinically significant differences in metabolic acidosis or blood urea nitrogen (BUN).
Methods The 46 ventilator-dependent preterm infants less than 1000g were retrospectively enrolled. The Early group received ≥ 3 g/kg/d amino acids, while the Late group did not received a minimum of ≥ 3 g/kg/d parenteral AA at ≤ 3 days of age.
Results An earlier, more aggressive administration of amino acids (≥ 3 g/kg/d amino acids at ≤ 3 days of age), was safe and well-tolerated, without clinically significant differences in metabolic acidosis or BUN. There is no correlation between amino acid intake and BUN in ELBW infants within 7 days of life, Using multiple regression analysis, gestational age showed a significant negative correlation with BUN concentrations in ELBW infants within 7 days of life.
Conclusions High BUN in the early postnatal period might be related not only to amino acid oxidation and the infant’s immaturity but also additional combined factors other than amino acid intolerance. Future studies are required to determine whether early and aggressive administration of amino acids is enough for optimal growth and neurodevelopmental outcome of ELBW infants.