Early TPN in VLBW infants

A randomized trial compared three parenteral nutritional regimens in VLBW infants that were all started at birth. The control group received amino acid alone (2.4 grams per kg per day of AA). One intervention group received the same amount of amino acids but also received intravenous lipids at a dose of 2 – 3 grams per kg per day. The second intervention group received the same amount of lipids but received a higher amount of amino acids (3.6 grams per kg per day). Compared to the control group, both intervention groups had better nitrogen balance. The higher dose of amino acids did not lead to better nitrogen balance and caused higher plasma urea levels. There were no differences in growth or clinical outcomes between the three groups.

 Safety and efficacy of early parenteral lipid and high-dose amino acids. Vlaardingerbroek et al, 2013