Hoehn G J, Carey D E, Rowe J C, Horak E, Raye J R
Department of Pediatrics, University of Connecticut Health Center, Farmington 06032.
J Pediatr Gastroenterol Nutr. 1987 Sep-Oct;6(5):752-7. doi: 10.1097/00005176-198709000-00016.
Very low birth weight infants require greater intakes of calcium and phosphate than can be supplied simultaneously in parenteral nutrition. We investigated the biochemical effects and retention of calcium and phosphate when each was administered for 24 h on an alternate day schedule as part of total parenteral nutrition. Serum and urine were collected during a 24 h basal period and during randomly ordered 24 h infusions of either calcium or phosphate in 14 infants during the first week of life. In general, the urinary excretion of the infused mineral (calcium or phosphorus) increased during the 24 h period of its infusion. The serum phosphorus level fluctuated widely from day to day while the serum calcium level did not change. During the 24 h infusion of phosphate, phosphate retention was 67.9 +/- 7.4% and, during the 24 h infusion of calcium, calcium retention was 72.5 +/- 4.3%. However, ongoing excretion of each mineral on the day it was not infused meant that 48.3% of the 48 h phosphate intake and 42.2% of the 48 h calcium intake were lost in the urine. We conclude that excessive amounts of the administered mineral were excreted and that alternate day infusion of calcium and phosphate is an unsatisfactory method for providing these minerals. Attainment of sufficient retentions of calcium and phosphate will require development of novel methods of simultaneous administration which provide calcium and phosphate in high concentrations.
极低出生体重儿对钙和磷的需求量，比肠外营养中同时提供的量要大。我们研究了在全肠外营养中，钙和磷按隔日给药24小时时的生化效应及潴留情况。在出生后第一周，对14例婴儿在24小时基础期以及随机安排的24小时钙或磷输注期间收集血清和尿液。一般来说，在输注所给矿物质（钙或磷）的24小时期间，其尿排泄量增加。血清磷水平每日波动很大，而血清钙水平没有变化。在输注磷的24小时期间，磷潴留为67.9±7.4%，在输注钙的24小时期间，钙潴留为72.5±4.3%。然而，在未输注矿物质的当天，每种矿物质仍持续排泄，这意味着48小时磷摄入量的48.3%和48小时钙摄入量的42.2%经尿液流失。我们得出结论，所给矿物质的过量部分被排泄，隔日输注钙和磷是提供这些矿物质的一种不理想方法。要实现足够的钙和磷潴留，将需要开发新的同时给药方法，以高浓度提供钙和磷。
