Associative Tolerance of Intravenously Administered Lipid and Gestational Age in Preterm Infants Receiving Total Parenteral Nutrition

Aim. The aim of this study is to investigate the effect of constant amount of lipid during total parenteral nutrition (TPN), by the evaluation of serum levels of: total cholesterol, triglycerides, free fatty acids, billirubin, AST, ALT, acid base status in the group of sick preterm infants. Material and methods. The tolerance for intravenously administered lipid (IL), with a maximal daily dose of 2.5 gr/kg, in 20 sick preterm infants during total parenteral nutrition was analyzed by controlling the total serum lipid level; the total cholesterol; the serum triglycerides concentration; the free fatty acids levels; the lipoprotein electrophoresis; the bilirubin level (total, conjugated and unconjugated); ALT and AST; the blood hemoglobin; erythrocyte, leukocyte and reticulocyte count; hematocrit; and the acid base status in capillary, venous and arterial blood. Results. A serum triglyceride concentration 2.0 mmol/l in 2 (10%). Hypertriglyceridemia >1.5 mmol/l was found in 4 patients with perinatal asphyxia and one with septicemia. There is a highly significant inverse correlation (p<0.001) between birth weight, gestational age and serum triglyceride level. The other analysis made for control of lipid tolerance were normal except the lower oxygen saturation levels such as pO 2 and increased pCO 2 , derived from patients with RDSy. An important increase in body weight was signed: 24.948 gr/gr infused protein/24h, 45.528gr/418 KJ energy/24h, 22.078gr/kg body weight/24h. Conclusion. Our study showed that the intake of 2.5 g/kg/day proteins and 2.5 g/kg/ day IL can be tolerated without metabolic or respiratory complications, and can also prevent the development of negative nitrogen balance seen in the conventional management of delivering glucose alone.