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Parenteral amino acid intakes in critically ill children: a matter of convenience.
JPEN J Parenter Enteral Nutr 2010 May-Jun; 34(3):329-40JJ

Abstract

BACKGROUND

Parenteral and enteral amino acid requirements for nutrition balance and function have not been defined in critically ill children or adults. In addition to playing a role in protein synthesis, amino acids trigger signaling cascades that regulate various aspects of fuel and energy metabolism and serve as precursors for important substrates. Amino acids can also be toxic. In this study, parenteral intakes of essential and nonessential amino acids (EAAs and NEAAs) supplied to critically ill children were assessed as an initial step for further studies aimed at establishing parenteral amino acid requirements.

METHODS

A retrospective review was conducted to assess intakes of parenteral amino acid for 116 critically ill children, and these intakes were compared with EAA intakes recommended by the Institute of Medicine. Because there are no recommended intakes for NEAA, NEAA intakes were compared with mixed muscle protein content in the older children and breast milk amino acid content in the infants.

RESULTS

Parenteral EAAs were provided in amounts that exceeded recommended intakes for healthy children, except for phenylalanine and methionine, which although excessive, were given in less generous amounts. NEAAs were supplied in lower or higher amounts than the content of mixed muscle proteins or breast milk. Parenteral amino acid formulas are limited in taurine, glutamine, and asparagine despite the fact that inflammatory/immune proteins are rich in these amino acids.

CONCLUSIONS

Amino acid composition of parenteral formulas is variable and lacks scientific support. Parenteral amino acid intakes should be based on measured requirements to maintain nutrition and functional balance and on knowledge of toxicity.

Authors+Show Affiliations

Critical Care Section, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

20093426

Citation

Verbruggen, Sascha, et al. "Parenteral Amino Acid Intakes in Critically Ill Children: a Matter of Convenience." JPEN. Journal of Parenteral and Enteral Nutrition, vol. 34, no. 3, 2010, pp. 329-40.
Verbruggen S, Sy J, Arrivillaga A, et al. Parenteral amino acid intakes in critically ill children: a matter of convenience. JPEN J Parenter Enteral Nutr. 2010;34(3):329-40.
Verbruggen, S., Sy, J., Arrivillaga, A., Joosten, K., van Goudoever, J., & Castillo, L. (2010). Parenteral amino acid intakes in critically ill children: a matter of convenience. JPEN. Journal of Parenteral and Enteral Nutrition, 34(3), pp. 329-40. doi:10.1177/0148607109347897.
Verbruggen S, et al. Parenteral Amino Acid Intakes in Critically Ill Children: a Matter of Convenience. JPEN J Parenter Enteral Nutr. 2010;34(3):329-40. PubMed PMID: 20093426.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Parenteral amino acid intakes in critically ill children: a matter of convenience. AU - Verbruggen,Sascha, AU - Sy,Jama, AU - Arrivillaga,Ana, AU - Joosten,Koen, AU - van Goudoever,Johaness, AU - Castillo,Leticia, Y1 - 2010/01/21/ PY - 2010/1/23/entrez PY - 2010/1/23/pubmed PY - 2010/10/21/medline SP - 329 EP - 40 JF - JPEN. Journal of parenteral and enteral nutrition JO - JPEN J Parenter Enteral Nutr VL - 34 IS - 3 N2 - BACKGROUND: Parenteral and enteral amino acid requirements for nutrition balance and function have not been defined in critically ill children or adults. In addition to playing a role in protein synthesis, amino acids trigger signaling cascades that regulate various aspects of fuel and energy metabolism and serve as precursors for important substrates. Amino acids can also be toxic. In this study, parenteral intakes of essential and nonessential amino acids (EAAs and NEAAs) supplied to critically ill children were assessed as an initial step for further studies aimed at establishing parenteral amino acid requirements. METHODS: A retrospective review was conducted to assess intakes of parenteral amino acid for 116 critically ill children, and these intakes were compared with EAA intakes recommended by the Institute of Medicine. Because there are no recommended intakes for NEAA, NEAA intakes were compared with mixed muscle protein content in the older children and breast milk amino acid content in the infants. RESULTS: Parenteral EAAs were provided in amounts that exceeded recommended intakes for healthy children, except for phenylalanine and methionine, which although excessive, were given in less generous amounts. NEAAs were supplied in lower or higher amounts than the content of mixed muscle proteins or breast milk. Parenteral amino acid formulas are limited in taurine, glutamine, and asparagine despite the fact that inflammatory/immune proteins are rich in these amino acids. CONCLUSIONS: Amino acid composition of parenteral formulas is variable and lacks scientific support. Parenteral amino acid intakes should be based on measured requirements to maintain nutrition and functional balance and on knowledge of toxicity. SN - 1941-2444 UR - https://www.unboundmedicine.com/medline/citation/20093426/Parenteral_amino_acid_intakes_in_critically_ill_children:_a_matter_of_convenience_ L2 - https://doi.org/10.1177/0148607109347897 DB - PRIME DP - Unbound Medicine ER -