Parenteral amino acid intakes in critically Ill children

A matter of convenience

Sascha Verbruggen, Jama Sy, Ana Arrivillaga, Koen Joosten, Johaness Van Goudoever, Leticia Castillo

Research output: Contribution to journalArticle

12 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)329-340
Number of pages12
JournalJournal of Parenteral and Enteral Nutrition
Volume34
Issue number3
DOIs
StatePublished - Jan 1 2010
Externally publishedYes

Fingerprint

Critical Illness
Amino Acids
Muscle Proteins
Human Milk
Nutritional Requirements
National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division
Essential Amino Acids
Poisons
Asparagine
Taurine
Glutamine
Phenylalanine
Methionine
Energy Metabolism
Small Intestine
Proteins

Keywords

  • Amino acids
  • Essential
  • Intensive care units
  • Parenteral nutrition
  • Pediatric

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Parenteral amino acid intakes in critically Ill children : A matter of convenience. / Verbruggen, Sascha; Sy, Jama; Arrivillaga, Ana; Joosten, Koen; Van Goudoever, Johaness; Castillo, Leticia.

In: Journal of Parenteral and Enteral Nutrition, Vol. 34, No. 3, 01.01.2010, p. 329-340.

Research output: Contribution to journalArticle

Verbruggen, Sascha ; Sy, Jama ; Arrivillaga, Ana ; Joosten, Koen ; Van Goudoever, Johaness ; Castillo, Leticia. / Parenteral amino acid intakes in critically Ill children : A matter of convenience. In: Journal of Parenteral and Enteral Nutrition. 2010 ; Vol. 34, No. 3. pp. 329-340.
@article{a982974ce6e34d80aac2ed70caaa1b42,
title = "Parenteral amino acid intakes in critically Ill children: A matter of convenience",
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.",
keywords = "Amino acids, Essential, Intensive care units, Parenteral nutrition, Pediatric",
author = "Sascha Verbruggen and Jama Sy and Ana Arrivillaga and Koen Joosten and {Van Goudoever}, Johaness and Leticia Castillo",
year = "2010",
month = "1",
day = "1",
doi = "10.1177/0148607109347897",
language = "English (US)",
volume = "34",
pages = "329--340",
journal = "JPEN. Journal of parenteral and enteral nutrition",
issn = "0148-6071",
publisher = "SAGE Publications Inc.",
number = "3",

}

TY - JOUR

T1 - Parenteral amino acid intakes in critically Ill children

T2 - A matter of convenience

AU - Verbruggen, Sascha

AU - Sy, Jama

AU - Arrivillaga, Ana

AU - Joosten, Koen

AU - Van Goudoever, Johaness

AU - Castillo, Leticia

PY - 2010/1/1

Y1 - 2010/1/1

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.

AB - 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.

KW - Amino acids

KW - Essential

KW - Intensive care units

KW - Parenteral nutrition

KW - Pediatric

UR - http://www.scopus.com/inward/record.url?scp=77953665567&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953665567&partnerID=8YFLogxK

U2 - 10.1177/0148607109347897

DO - 10.1177/0148607109347897

M3 - Article

VL - 34

SP - 329

EP - 340

JO - JPEN. Journal of parenteral and enteral nutrition

JF - JPEN. Journal of parenteral and enteral nutrition

SN - 0148-6071

IS - 3

ER -