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极低出生体重儿(≤1000克)在三个时间段内的早期氨基酸与代谢反应

Early amino acids and the metabolic response of ELBW infants (< or = 1000 g) in three time periods.

作者信息

Radmacher P G, Lewis S L, Adamkin D H

机构信息

Department of Pediatrics, University of Louisville, Louisville, KY 40292, USA.

出版信息

J Perinatol. 2009 Jun;29(6):433-7. doi: 10.1038/jp.2009.36. Epub 2009 Apr 2.

Abstract

OBJECTIVE

To evaluate early amino-acid (AA) administration in extremely low birth weight (ELBW) infants over three time periods, beginning with the initiation of this strategy.

STUDY DESIGN

This was a retrospective study of ELBW infants between 2000 and 2007. Nutritional intake and laboratory results were monitored during the first 5 days of life. Growth rates and complications were followed until discharge.

RESULT

Infants were similar in birth weight (BW), gestational age (GA) and severity of illness. The age at initiation of AA decreased significantly over time. Age at weight nadir, return to BW and percent postnatal weight loss decreased in epoch 3. There were modest increases in blood urea nitrogen (BUN), but no significant metabolic disturbances were observed. Cholestasis was more prevalent in epoch 2.

CONCLUSION

AA administration within the first hours of life appears to be safe and beneficial for ELBW infants. Absent signs of renal dysfunction, a modest rise in BUN is consistent with the neonate's utilization of AAs for energy.

摘要

目的

从该策略实施开始,评估极低出生体重(ELBW)婴儿在三个时间段内早期给予氨基酸(AA)的情况。

研究设计

这是一项对2000年至2007年间ELBW婴儿的回顾性研究。在出生后前5天监测营养摄入和实验室检查结果。随访生长速率和并发症直至出院。

结果

婴儿在出生体重(BW)、胎龄(GA)和疾病严重程度方面相似。开始给予AA的年龄随时间显著降低。第3阶段体重最低点的年龄、恢复至出生体重的年龄和出生后体重减轻百分比均降低。血尿素氮(BUN)有适度升高,但未观察到明显的代谢紊乱。胆汁淤积在第2阶段更为普遍。

结论

出生后数小时内给予AA对ELBW婴儿似乎是安全且有益的。在没有肾功能障碍迹象的情况下,BUN适度升高与新生儿利用AA获取能量一致。

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