Administering different levels of parenteral phosphate and amino acids did not influence growth in extremely preterm infants

• Published in: Acta Paediatrica Vol. 104; no. 9; pp. 894 - 899
• Main Authors: Moe, Katrine, Beck-Nielsen, Signe Sparre, Lando, Ane, Greisen, Gorm, Zachariassen, Gitte
• Format: Journal Article
• Language: English
• Published: Norway Blackwell Publishing Ltd 01-09-2015; Wiley Subscription Services, Inc
• Subjects: Amino Acids - administration & dosage; Calcium - blood; Extremely preterm infants; Female; Humans; Infant, Extremely Premature; Infant, Newborn; Infant, Premature, Diseases - therapy; Male; Parenteral Nutrition; Parenteral Nutrition Solutions; Phosphate; Phosphates - administration & dosage; Phosphates - blood; Postnatal growth; Retrospective Studies; Small for gestational age; Weight Gain; Parenteral nutrition; Postnatal growth; Small for gestational age; Phosphate; Extremely preterm infants
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/apa.13063

Aim
When a new high amino acid parenteral nutrition (PN) solution was introduced to our hospital, a design error led to decreased phosphate levels. This prompted us to examine the effect of three different PN solutions on plasma phosphate, plasma calcium and weight increases on extremely preterm infants.
Method
This was a retrospective study of 186 infants with a gestational age of <28 weeks during their first month of life. They were divided into three groups based on the PN they received during hospitalisation. Group one received high levels of phosphate and low levels of amino acids. Group two received low levels of phosphate and high levels of amino acids. Group three received high levels of both phosphate and amino acids.
Results
The lowest plasma phosphate values varied significantly between groups one (1.80 ± 0.46 mmol/L), two (1.05 ± 0.48 mmol/L) and three (1.40 ± 0.37 mmol/L) (p < 0.001), but no significant difference in weight increase was seen (p = 0.497).
Conclusion
The phosphate content of the PN influenced plasma phosphate and plasma calcium levels, but increasing the levels of both phosphate and amino acids did not improve weight gain during the first month of life.