Phenylalanine, Methionine and Histidine Requirements in TPN Fed Neonates
Phenylalanine, Methionine and Histidine Requirements in Total Parenteral Nutrition (TPN) Fed Neonates
The Hospital for Sick Children
60 participants
Apr 2, 2023
INTERVENTIONAL
Conditions
Summary
This is a single center project assessing the requirements for three essential amino acids in TPN fed neonates. Using the Carbon Oxidation method (indicator amino oxidation and direct amino acid oxidation method), the investigators will determine the requirement of each of the 3 amino acids. The investigators will first determine the requirement for Phenylalanine, then Methionine and finally Histidine. The investigators will recruit 18 - 20 babies per amino acid study. Breath and urine samples will be collected to determine the oxidation of the indicator amino acid. The response of the indicator amino acid to changes in intake of the test amino acid (phenylalanine, methionine, and histidine) will be analyzed by bi-phase linear mixed effect model to determine the breakpoint or mean requirement for each amino acid. It is hypothesized that the requirement for phenylalanine, methionine and histidine will be at least 50% lower than what is currently available in commercial amino acids solutions used for TPN feeding of neonates.
Eligibility
Inclusion Criteria7
- Stable preterm babies that are growing and fully TPN fed (at least 90% of calories and protein).
- TPN providing adequate calories and protein as determined by attending physician and dietitian.
- Babies born ≥ 28 weeks gestation,
- ≤ 28 days chronological age at the time of the study,
- Birth weight and length appropriate for gestational age,
- Medically stable as determined by normal blood results and lack of a fever or infection,
- At least 3 days after surgery, if the baby had a surgery.
Exclusion Criteria6
- Babies on mechanical ventilation, on low flow oxygen and CPAP.
- Small for gestational age,
- On medications known to affect protein and amino acid metabolism,
- Documented infection, fever
- Unstable medical condition
- Receiving enteral feeding providing \> 10% of protein intake.
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Interventions
phenylalanine, methionine and histidine intakes will be varied in the TPN solutions to study the requirements for each of these amino acids in neonates that are TPN fed.
Locations(1)
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NCT05562310