• María Salomé Anaya-Flórez, Lourdes Barbosa-Cortés, Miguel Angel Villasis-Keever, Silvia Aguilar-Monroy, Irene Montalvo-Velarde, Mardia López-Alarcón, Martha Lledias-Corona, Andrea Huerta-Tecanhuey, Jorge Maldonado-Hernández, Olivia Madrigal-Muñiz, and Héctor González-Cabello.
• Department of Parenteral and Enteral Nutrition, Pediatric Hospital, 21st Century National Medical Center, Mexican Institute of Social Security (IMSS), Mexico City, Mexico.
• Nutrition. 2019 Sep 1; 65: 202-207.

ObjectiveIn neonates on total parenteral nutrition (TPN), amino acids may be a risk factor for developing total parenteral nutrition-associated cholestasis (TPNAC). We aimed, first, to compare methionine, cysteine, and taurine plasma levels between neonates on TPN who were receiving an intravenous amino acid solution based on a breast milk aminogram and those on an intravenous solution of pediatric amino acids based on an umbilical cord aminogram, and second, to determine the frequency of TPNAC.MethodsA double-blind randomized controlled trial was conducted. Ninety-four neonates with a birthweight of 1000g or more and a gestational age of 30 wk or older were admitted and enrolled. Blood samples were obtained at 0, 7, and 14 d of TPN, and plasma amino acid concentrations were determined by ultra-high-resolution liquid chromatography. Continuous variables were compared using the Wilcoxon rank-sum test or Student's t test; categorical variables were compared using the Fisher exact test.ResultsThirty-five neonates completed the study (Primene, n = 14; TrophAmine, n = 21). On day 14, methionine plasma concentrations were significantly lower in the Primene group than in the TrophAmine group (27 µmol/L versus 32.9 µmol/L, P = 0.044); the taurine concentration was significantly higher in the same group (72.4 µmol/L versus 45.3 µmol/L, P < 0.0001). There were no differences in TPNAC incidence.ConclusionsAdministering an intravenous solution of pediatric amino acids based on the umbilical cord aminogram yielded a higher taurine and lower methionine plasma concentration than did administering a similar solution based on the breast milk aminogram.Copyright © 2018 Elsevier Inc. All rights reserved.

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