Published online January 2, 2008
PEDIATRICS Vol. 121 Supplement January 2008, pp. S99-S100 (doi:10.1542/peds.2007-2022AA)
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COMMUNITY PEDIATRICS


A DOUBLE-BLIND RANDOMIZED, CONTROLLED TRIAL OF PROTEIN ENERGY–ENRICHED FORMULA ADMINISTERED TO CRITICALLY ILL INFANTS

Dick Van Waardenburga, Carlijn De Betuea and Koen Joostenb

a Department of Pediatrics, Maastricht University Hospital, Maastricht, Netherlands
b Department of Pediatrics, Erasmus Medical Center-Agia Sophia Children's Hospital, Rotterdam, Netherlands

ABSTRACT

INTRODUCTION: Nutritional support is an important aspect of clinical management of critically ill infants, but the nutritional requirements of these infants are not well defined.

OBJECTIVE: Our goal was to compare tolerance, nutritional, and metabolic effects of 2 different infant formulas in critically ill infants in a double-blind, randomized way.

METHODS: Eighteen ventilated infants with respiratory insufficiency caused by respiratory syncytial virus infection were included and received an energy- and protein-enriched (PE) infant formula (Infatrini [Nutricia B. V. Zoetermeer, Zoetermeer, Netherlands]; n = 8) or standard infant formula (Nutrilon 1 [Nutricia B. V. Zoetermeer]; n = 10). Daily intake and tolerance (gastric retention, diarrhea) were recorded. Resting energy expenditure, respiratory quotient, L-amino acid concentrations, and metabolic parameters were measured, and cumulative energy balance, nitrogen balance, and substrate utilization were calculated.

RESULTS: Baseline characteristics were similar in both groups. Both formulas were well tolerated with similar volumes of intake. Results from day 4 are presented in Table 1. Levels of several amino acids (His, Val, Met, Phe, Lys, and ornithine; P < .05) were significantly higher in the infants who received the PE-enriched formula.


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  		TABLE 1. Results on Day 4 of Admission

 
CONCLUSIONS: PE-enriched infant formula was well tolerated in critically ill infants and effective in achieving higher nutritional intakes in the first days of admission. PE-enriched formula improved energy balance and plasma amino acid profile, and a trend toward increased nitrogen balance was found.

Submitted by Dick Van Waardenburg