ABSTRACT
Indices of respiratory muscle strength, pulmonary function, and pulmonary diffusing capacity were measured in 11 malnourished children (age 10 to 17 years) with cystic fibrosis, before and after improvement of nutritional status with supplemental parenteral nutrients for 1 month. During this time, the children received 120% of estimated energy requirements (either 3.75% or 22.5% as lipid) and amino acids 2.5 gm/120 kcal by central venous catheter, plus as much of their usual diet as desired. With nutritional supplementation, body weight, triceps skinfold thickness, and mid-arm muscle circumference increased (mean 15%, 62%, and 95%, respectively). Maximum inspiratory airway pressure also increased (mean 29%; P less than 0.01), suggesting improvement in respiratory muscle strength. However, none of the indices of pulmonary function improved. Pulmonary diffusing capacity did not change during parenteral nutrition regardless of the amount of parenteral energy intake supplied by lipid, but arterial oxygen saturation decreased (mean of 93.5% to 91.5%; P less than 0.005). During the month following parenteral nutrition, weight, skinfold thickness, and mid-arm muscle circumference, but not MIP, decreased and arterial oxygen saturation returned to the initial value (P less than 0.01).
Subject(s)
Cystic Fibrosis/therapy , Lung/physiopathology , Parenteral Nutrition, Total , Parenteral Nutrition , Adolescent , Anthropometry , Child , Cystic Fibrosis/physiopathology , Evaluation Studies as Topic , Female , Humans , Male , Pulmonary Gas Exchange , Respiratory Function Tests , Time FactorsABSTRACT
Intestinal fat absorption and anthropometric and clinical variables were monitored weekly in 21 low-birth-weight (LBW) infants fed either a whey-predominant cow's-milk formula (formula 1) or identical formulas with medium-chain triglycerides (MCTs) comprising 40% (formula 2) or 80% (formula 3) of the fat content. Fat absorption of infants fed formula 1 averaged 86.7% of intake, whereas that of infants fed formulas 2 and 3 averaged 93.8% and 95.4%, respectively. However, no differences in weight, length, head circumference, or skin fold thickness were observed. Moreover, intestinal symptoms were encountered more frequently in infants fed formulas 2 and 3. This demonstrated failure of the resulting small increase in fat absorption incident to MCTs either to promote enhanced growth or to confer obvious clinical benefit does not support the increasing use of MCT formulas for routine feeding of LBW infants.
Subject(s)
Infant, Low Birth Weight , Triglycerides/therapeutic use , Diet Therapy , Food Additives , Growth , Humans , Infant , Infant Food/standards , Infant Nutritional Physiological Phenomena , Infant, Newborn , Intestinal Absorption , Triglycerides/administration & dosageABSTRACT
A controlled study comparing two intravenous fluid regimens was performed in sick, premature infants. The regimens were isocaloric at 60 calories/kg/day, one providing glucose alone, the other glucose plus 2.5 gm/kg of amino acids. There was no difference in changes in body weight between the two groups; infants receiving glucose alone were in negative nitrogen balance; those receiving glucose plus amino acids were in positive nitrogen balance. Plasma amino acid values were compared to published, postprandial normal values. The TEAA and TAA of infants receiving amino acids were not different from normal. Values of TEAA and TAA of infants receiving glucose alone were significantly lower. Essential fatty acid deficiency developed in infants receiving amino acids but not in those receiving glucose alone. It is concluded that the glucose plus amino acid regimen results in anabolism without undue metabolic costs.
