Isoleucine, Leucine, Valine and Tryptophan Requirements in TPN Fed Neonates
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Total parenteral nutrition (TPN): this is total nutrition provided by central vein..
- Who it may be relevant to
- Registry conditions: Neonates on TPN, Stable Neonates, Neonates Managed in the ICU. Basic parameters: 1 Day — 28 Days · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Brazil
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Isoleucine, Leucine, Valine and Tryptophan Requirements in Total Parenteral Nutrition (TPN) Fed Neonates
Overview
This project will be conducted in 2 hospitals in Brazil to assess the requirements for four 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 4 amino acids. The investigators will determine the requirement for Isoleucine, Leucine, Valine and Tryptophan. 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 (isoleucine, leucine, valine and tryptophan) 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 isoleucine, leucine, valine and tryptophan will be at least 50% lower than what is currently available in commercial solutions used for TPN feeding of neonates.
Detailed description
The study is based on the carbon oxidation protocol. Each baby will receive one or two levels of either isoleucine or leucine or valine or tryptophan. Each level will be assessed over a two- day period.
On day 1: each baby will receive a standard pediatric amino acid solution, Primene used in the NICU and L-\[1-13C\]Na Bicarbonate will be given to measure carbon dioxide production.
On day 2: he/she will receive the appropriate TPN Test Solution made up of the appropriate Bulk Amino Acid solution (for Isoleucine/ Leucine/ Valine/ Tryptophan Studies) with a different amount of the amino acid being investigated. To see how these amino acids are used in the body the investigators will add a small amount (calculated based on the body weight of the baby) of the amino acid L-\[1-13C\]phenylalanine to the amino acid solution. Breath and urine will be collected from the baby to study the oxidation of the L -\[1-13C\]phenylalanine. The investigators will take 2 x 0.75 ml blood to measure plasma amino acid concentration. The investigators will aim to coordinate blood taking with routine blood work done for clinical monitoring.
Interventions
- Drug Total parenteral nutrition (TPN): this is total nutrition provided by central vein.
isoleucine, leucine, valine and tryptophan intakes will be varied in the TPN solutions to study the requirements for each of these amino acids in neonates that are TPN fed.
Primary outcome measures
- Amino acid oxidation using a labelled amino acid. [Time frame: 48 hrs]
Eligibility criteria
Inclusion criteria
- 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 criteria
- 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
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- N/A
- Model
- Single group
- Masking
- Open label
- Primary purpose
- Other
Study locations
Brazil · 1 center
- Hospital de Caridade Dr. Astrogildo de Azevedo, and University Hospital of Santa Maria, Sa — Santa Maria
Identifiers
NCT: NCT06372314 · 1000081221