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Plasma Ammonia Levels in Preterm Infants Receiving Parenteral Nutrition with Crystalline L-Amino Acids

Neonatal Department, Beilinson Medical Center, Petach Tiqua, Tel Aviv University, Sackler School of Medicine, Israel

E. Wielunsky, M.D.

Neonatal Department, Beilinson Medical Center, Petach Tiqua, Tel Aviv University, Sackler School of Medicine, Israel

S.H. Reisner, M.B.CH.B.

Neonatal Department, Beilinson Medical Center, Petach Tiqua, Tel Aviv University, Sackler School of Medicine, Israel

In order to investigate the severity and incidence of hyperammonemia in preterm infants receiving total parenteral nutrition (TPN) with crystalline L-amino acids having high arginine content (Travasol), we determined the plasma ammonia (PA) levels in a group of 29 preterm infants on TPN, weekly and 1 wk posttherapy. Their mean gestational age was 29.9 ± 2.6 wk and mean birth weight 1208 ± 262 g. Thirty five blood samples obtained from 15 preterm infants not on TPN with mean gestational age 32.2 ± 1.9 wk and a birth weight of 1495 ± 161 g served as a control. In the parenteral nutrition group the mean PA level (140 ± 58 µg/100 ml) was significantly higher (p < 0.001) than that in the same group one week post TPN (97 ± 34 µg/100 ml) and in the control group (86 ± 35 µg/100 ml). The incidence of hyperammonemia (>160 µg/100 ml) was 30% in the TPN group versus 3% in the controls (p < 0.01). Maximal PA level during that treatment was 405 versus 216 µg/100 ml 1 wk post-TPN versus 163 µg/100 ml in the controls. The data show a significant increase in PA levels in preterm infants receiving TPN with Travasol, possibly because of its high glycine content. (Journal of Parenteral and Enteral Nutrition 8:178-180, 1984)

Journal of Parenteral and Enteral Nutrition, Vol. 8, No. 2, 178-180 (1984)
DOI: 10.1177/0148607184008002178


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