Regina M Reynolds1, Kathryn D Bass, Patti J Thureen. 1. Section of Neonatology, Department of Pediatrics, University of Colorado Health Sciences Center, Denver, Colorado 80262, USA. regina.reynolds@uchsc.edu
Abstract
OBJECTIVES: To determine whether neonates undergoing major abdominal surgical procedures in the first day of life could achieve a positive protein balance without protein toxicity in the immediate perioperative period by using parenteral amino acids and fentanyl analgesia. STUDY DESIGN: Newborns undergoing major surgery for gastroschisis in the first 24 hours of life (n = 13) were alternately allocated to immediate postoperative parenteral administration of 1.5 g/kg(-1)/day(-1) versus 2.5 g/kg(-1)/day(-1) amino acids. Protein balance was determined at 1.6 to 2.6 days postoperatively with both nitrogen balance and leucine stable isotope methodology. Statistical analyses were conducted with the unpaired t test and linear regression. RESULTS: Protein balance was significantly different in the 2 groups with both nitrogen balance and leucine stable isotope methodology. There was no evidence of protein toxicity as determined with blood urea nitrogen, creatinine, and ammonia concentrations. CONCLUSIONS: Neonates undergoing the metabolic stress of abdominal surgery shortly after birth are able to achieve a net positive protein balance with parenteral amino acid administration without evidence of protein intolerance.
OBJECTIVES: To determine whether neonates undergoing major abdominal surgical procedures in the first day of life could achieve a positive protein balance without protein toxicity in the immediate perioperative period by using parenteral amino acids and fentanyl analgesia. STUDY DESIGN: Newborns undergoing major surgery for gastroschisis in the first 24 hours of life (n = 13) were alternately allocated to immediate postoperative parenteral administration of 1.5 g/kg(-1)/day(-1) versus 2.5 g/kg(-1)/day(-1) amino acids. Protein balance was determined at 1.6 to 2.6 days postoperatively with both nitrogen balance and leucine stable isotope methodology. Statistical analyses were conducted with the unpaired t test and linear regression. RESULTS: Protein balance was significantly different in the 2 groups with both nitrogen balance and leucine stable isotope methodology. There was no evidence of protein toxicity as determined with blood ureanitrogen, creatinine, and ammonia concentrations. CONCLUSIONS: Neonates undergoing the metabolic stress of abdominal surgery shortly after birth are able to achieve a net positive protein balance with parenteral amino acid administration without evidence of protein intolerance.
Authors: Carlijn T I de Betue; Xiomara C Garcia Casal; Dick A van Waardenburg; Stephen M Schexnayder; Koen F M Joosten; Nicolaas E P Deutz; Marielle P K J Engelen Journal: Clin Nutr Date: 2017-01-04 Impact factor: 7.324
Authors: Carlijn T de Betue; Dick A van Waardenburg; Nicolaas E Deutz; Hans M van Eijk; Johannes B van Goudoever; Yvette C Luiking; Luc J Zimmermann; Koen F Joosten Journal: Arch Dis Child Date: 2011-06-14 Impact factor: 3.791