Effect of low versus high early parenteral nutrition on plasma amino acid profiles in very low birth-weight infants

Objective: To study the efficacy of early high doses parenteral nutrition (PN) versus early low dose with progressive increments PN regimens, we performed a prospective randomized study in very low birth-weight infants. Study design: Forty-one appropriate gestational age preterm infants with birth weights ranging from 750–1500 g were randomly assigned into two groups. In Group 1, infants started on 3.0 g/kg/day amino acids (AA) and 3 g/kg/day of 20% lipid; in Group 2, AA and lipid were started on 1 g/kg/day, and advanced over 3 days to a maximum 3 g/kg/day. Blood samples were obtained for AA concentrations before starting of the PN, and at the 7th and 14th days. Results: The mean (±SD) birth weight was 1335 g (240), gestational age was 29.7 weeks (1.7) of the study group. The mean body weight and head circumference was similar in the Group 1 and Group 2 at the 14th postnatal days. There was no difference in the blood levels of triglyceride, blood urea nitrogen, creatinine, ammonia, lactat and bicarbonate ...