Department of Odontostomatologic and Specialized Clinical Sciences, Polytechnic University of Marche and Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I - G. M. Lancisi - G. Salesi, Ancona, Italy.
Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.
Clin Nutr. 2021 Jan;40(1):153-156. doi: 10.1016/j.clnu.2020.04.039. Epub 2020 May 6.
Blood urea is considered a marker of amino acid utilization in preterm infants on routine parenteral nutrition. However, the association between blood urea and intravenous amino acid intake remains debated.
To evaluate the association between blood urea and both nutrition and clinical data, in a large cohort of preterm infants.
Consecutively admitted preterm infants with a gestational age of less than 32 weeks and a birth weight lower than 1250 g on routine parenteral nutrition from the first hour of life were studied. Clinical and nutrition data collected hourly during the hospitalization were used in multiple linear regression analysis.
We studied 674 patients and 1863 blood urea determinations. Blood urea concentration was positively associated with blood creatinine concentration, intravenous amino acid intake, patent ductus arteriosus and respiratory distress syndrome, and negatively associated with intravenous non-protein energy intakes, daily weight change, gestational age, being small for gestational age, antenatal steroids therapy and reverse flow in the umbilical artery (p < 0.001; R = 0.7).
From a nutrition perspective, in our large cohort of small preterm infants blood urea was positively correlated with intravenous amino acid intake and negatively correlated with intravenous non-protein energy intake. This is in line with current knowledge in human physiology and suggest that a reduction of intravenous amino acid intake based on blood urea concentrations was justified.
血尿素被认为是早产儿常规肠外营养中氨基酸利用的标志物。然而，血尿素与静脉内氨基酸摄入之间的关系仍存在争议。
评估大量早产儿队列中血尿素与营养和临床数据之间的关联。
从生命的第一个小时开始，对接受常规肠外营养的胎龄小于 32 周且出生体重低于 1250g 的早产儿进行连续入院。在住院期间每小时收集的临床和营养数据用于多元线性回归分析。
我们研究了 674 名患者和 1863 次血尿素测定。血尿素浓度与血肌酐浓度、静脉内氨基酸摄入、动脉导管未闭和呼吸窘迫综合征呈正相关，与静脉内非蛋白能量摄入、每日体重变化、胎龄、小于胎龄儿、产前类固醇治疗和脐动脉反向血流呈负相关（p<0.001；R=0.7）。
从营养角度来看，在我们的大量小早产儿队列中，血尿素与静脉内氨基酸摄入呈正相关，与静脉内非蛋白能量摄入呈负相关。这与人体生理学的现有知识一致，并表明根据血尿素浓度减少静脉内氨基酸摄入是合理的。
