Administração de Amnoácidos

8/4/2019 Administrao de Amnocidos

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A administrao precoce de aminocidosmelhora o peso dos recm-nascidos pr-

termosCJ Valentine, S Fernandez et alJournal of Perinatology2009; 29: 428-432

Internos:Jder Allan O. Lagares

Rubens Carneiro

Orientador: Dr. Paulo R. Margotto


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Ddos Jder e Rubens


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Early amino-acid administrationimproves preterm infant weight

CJ Valentine, S Fernandez, LK Rogers, P Gulati, J Hayes,P Lore, T

Puthoff, M Dumm1,6, A Jones1, K Collins1, J Curtiss1, K

Hutson1,6, K Clark1and SE Welty1,2,3

Journal of Perinatology2009; 29: 428-432


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Objetivo

Inicio precoce de aminocidos em RN


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Mtodos

Sujeitos: RN< 1500g, AIG, nascidos de2004 a 2006 que sobreviveram nas

prximas 2 semanas ao estudo Estudo prospectivo para a interveno

em RN


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Interveno

EAA incio de AA 3g/kg + glicose 6a 8 mg/kg nas primeiras 24h. Aps

24h aumentado glicose + emulsolipdica para 90Kcal/Kg/dia

LAA incio de AA 3g/kg + glicose 6 a

8 mg/kg aps 24h. Aps 48haumentado glicose + emulso lipdicapara 90Kcal/Kg/dia


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Resultados


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Discusso

A administrao precoce de aminocido temse mostrado segura e promove um balano

do nitrognio e tolerncia glicose em RNprematuros;

A anlise pelo score-z resultou em menosRN abaixo do percentil 10 em 36 semanasno grupo EAA em relao ao grupo LAA;


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Discusso

A anlise dos dados pela curva Fentontambm demonstrou uma menor proporo

de RN abaixo do percentil 10;

Outro ponto interessante do trabalho foi amenor durao da nutrio parenteral e oincio mais precoce da nutrio totalmenteenteral no grupo EAA;


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Discusso Neste estudo, o grupo EAA no teve uma

taxa de crescimento anormalmenteacelerado, na verdade o grupo LAA

apresentou uma maior proporo deretardo do crescimento;

A lentificao do ganho de peso estassociado a um baixo ndice dedesenvolvimento e ao aumento do risco

de paralisia cerebral;


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Discusso Uma taxa muita acelerada de ganho

ponderal est associada aodesenvolvimento de doena metablicatardiamente;

Apesar do grupo EAA ter um bomcrescimento extra-uterino, este ainda se

mostra inferior ao crescimento intra-uterino. Isto pode ser devido taxa de3g/kg de aminocido ser ainda

insuficiente;


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Discusso Este estudo apresentou como limitaes, o

componente retrospectivo paracomparaes e a falta dados sobre acintica das protenas;

Em resumo, este trabalho encontrou umaassociao entre a administrao precoce

de aminocido e uma menor falha docrescimento em comparao com aadministrao tardia deste substrato;


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Discusso

Estudos adicionais para determinar osefeitos da administrao precoce de

aminocido na cintica protica e aavaliao de intervenes nutricionaismais agressivas podem ser realizados.

No houve conflito de interesses.


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Abstract Objective: Premature infants, especially those born less than 1500 g, often exhibit slow

overall growth after birth and lack of early nutritional support may be an importantelement. We tested the hypothesis that early administration of amino acids (withinthe first few hours of life) to infants born at less than 1500 g would be associatedwith fewer infants that were less than the 10th percentile at 36 weeks post-conceptual age than infants that received amino acids after the first 24 h of life.

Study Design: A prospective intervention of early amino-acid (EAA) supplementation, began

before 24 h of life, in preterm infants,


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k&origin=npg&version=1.0&coi=1:STN:280:DyaL2M3mvFCmsg%3D%3D&pissn=0743-8346&pyear=2009&md5=e62f4187f2b54fcd05b69b19d521468ahttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?holding=npg&cmd=Retrieve&db=PubMed&list_uids=4022675&dopt=Abstracthttp://dx.doi.org/10.1203/00006450-198507000-00009http://chemport.cas.org/cgi-bin/sdcgi?APP=ftslink&action=reflink&origin=npg&version=1.0&coi=1:CAS:528:DC%2BD3cXivFymurY%3D&pissn=0743-8346&pyear=2009&md5=33d82a908fb4a669a5d9d829e0016443http://links.isiglobalnet2.com/gateway/Gateway.cgi?&GWVersion=2&SrcAuth=Nature&SrcApp=Nature&DestLinkType=FullRecord&KeyUT=000086644000020&DestApp=WOS_CPLhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?holding=npg&cmd=Retrieve&db=PubMed&list_uids=10799412&dopt=Abstracthttp://chemport.cas.org/cgi-bin/sdcgi?APP=ftslink&action=reflink&origin=npg&version=1.0&coi=1:STN:280:ByyD3MbpsFM%3D&pissn=0743-8346&pyear=2009&md5=c3b3636eee29739d7922e5c18fed0d2chttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?holding=npg&cmd=Retrieve&db=PubMed&list_uids=1403464&dopt=Abstracthttp://chemport.cas.org/cgi-bin/sdcgi?APP=ftslink&action=reflink&origin=npg&version=1.0&coi=1:STN:280:DyaK1M7is1Grsw%3D%3D&pissn=0743-8346&pyear=2009&md5=82902614665fc70d90f452222ac71ccchttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?holding=npg&cmd=Retrieve&db=PubMed&list_uids=9925837&dopt=Abstracthttp://dx.doi.org/10.1542/peds.103.2.434


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Consultem tambm:

Nutrio parenteral: quandoiniciarAutor(es): Mauro Silva de AthaydeBohrer (RS). Realizado por Paulo R.Margotto
http://www.paulomargotto.com.br/documentos/aa_precoce_nutricao.dochttp://www.paulomargotto.com.br/documentos/aa_precoce_nutricao.doc


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Segurana e eficcia do uso precoce deaminocidos em pr-termos


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Nutrio do recm-nascido pr-termo: desnutrio ps-natal,

otimizao do crescimento,nutrio ps-altaAutor(es): Richard Cooke (EUA).Realizado por Paulo R. Margotto

OBRIGADO!
http://www.paulomargotto.com.br/documentos/Nutricao_pre_termo.dochttp://www.paulomargotto.com.br/documentos/Nutricao_pre_termo.doc


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OBRIGADO!

Dr. Paulo R. Margotto, Ddos Rubens, Gabriela e Jder

Administração de Amnoácidos

Documents

Transcript of Administração de Amnoácidos