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PS-265 Insulin Treated Hyperglycaemia, Hyperalimentation And Metabolic Changes Associated With Growth In Very Preterm Infants Receiving Parenteral Nutrition
  1. J Green,
  2. L Burgess,
  3. C Morgan
  1. Neonatology, Liverpool Women’s Hospital, Liverpool, UK

Abstract

Background Hyperalimentation using a Standardised, Concentrated, Added Macronutrients Parenteral (SCAMP) nutrition regimen improves early head growth, particularly in association with insulin-treated hyperglycaemia (ITH). Early postnatal growth is associated with increased potassium/phosphate supplementation and lower plasma amino acids (AA). We hypothesised that infants randomised to SCAMP and undergoing ITH would demonstrate metabolic changes associated with growth.

Methods SCAMP and control groups were identified from the previously published RCT (ISRCTN 76597892). Infants were substratified into ITH and non-ITH within their original group randomisation. Actual mean daily protein/energy intake, weekly growth and secondary metabolic outcome data, including daily electrolyte intake (including supplementary electrolytes), daily plasma electrolyte and weekly AA (profile: 23 individual AA plasma levels) were collected.

Results Table 1 shows mean (sd) daily intake (MDI) protein/energy intake. The change (Δ) in OFC data demonstrate improved growth with ITH/SCAMP. The percentage of infants requiring electrolyte supplementation (Ksupp/Psupp) was higher in ITH versus non-ITH infants. 17/23 plasma AA were lower in SCAMP ITH versus non-ITH infants (p < 0.05 for cysteine, arginine, glutamine, tryptophan, tyrosine, ornithine, methionine) whereas only 5/23 AA were lower in control ITH versus non-ITH (ns).

Abstract PS-265 Table 1

Conclusions ITH, hyperalimentation and growth is associated with increased potassium/phosphate supplementation and lower plasma AA.

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