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Total Parenteral Nutrition in Very Low Birth Weight Infants with Travasol 10% Blend C

Perinatal Service and Research Center of St. Justine's Hospital, and the Department of Pediatrics and Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada

Philippe Chessex, M.D., F.R.C.P. C

Perinatal Service and Research Center of St. Justine's Hospital, and the Department of Pediatrics and Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada

Danielle Lepage

Perinatal Service and Research Center of St. Justine's Hospital, and the Department of Pediatrics and Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada

Louis Dallaire, M.D., PH.D.

Perinatal Service and Research Center of St. Justine's Hospital, and the Department of Pediatrics and Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada

Gilles Brisson, PH.D.

Perinatal Service and Research Center of St. Justine's Hospital, and the Department of Pediatrics and Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada

Ijaz Qureshi, PH.D.

Perinatal Service and Research Center of St. Justine's Hospital, and the Department of Pediatrics and Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada

Ten very low birth weight (VLBW) infants (birth weight: 994 ± 66 g, gestational age: 27 ± 0.5 wk) requiring total parenteral nutrition (TPN) were studied in order to evaluate their metabolic response to the amino acid solution Travasol 10% blend C. These patients received the solution at a constant rate, providing 2.61 ± 0.02 g/kg/day of amino acids and 76 ± 1 kcal/kg/day. Plasma amino acids analysis was performed after 4.6 ± 0.3 day of infusion and compared to values reported previously with Travasol blend B. The new solution (blend C) showed a significantly lower (p < 0.001) glycinemia (485 ± 24 vs 993 ± 69 µmol/liter), methioninemia (39 ± 2 vs 114 ± 12 µmol/liter) and phenylalaninemia (67 ± 3 vs 92 ± 5 µmol/liter) related to the lower intake of these amino acids. Despite the provision of 47.5 mmol/liter of serine with blend C no changes in plasma level (182 ± 15 vs 196 ± 41 µmol/ liter) were noted. The increased molar arginine/glycine ratio (blend C: 0.48 vs blend B 0.22) could have contributed to keep ammoniemia within normal levels (55.1 ± 4.2 µmol/liter). Wide variations in insulin response (9.9 to 26.4 µU/ml) allowed for a correlation between its plasma concentration and those of sensitive amino acids, underlining its role in protein metabolism. Despite the immaturity of the study population no short-term metabolic imbalance has been encountered with the Travasol blend C solution. (Journal of Parenteral and Enteral Nutrition 10:296-299, 1986)

Journal of Parenteral and Enteral Nutrition, Vol. 10, No. 3, 296-299 (1986)
DOI: 10.1177/0148607186010003296


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