Abstract
Plasma substrate response and lipid tolerance were examined in VLBW infants during parenteral alimentation (PA) with or without intralipid (IL) infusions. 21 infants, age 2-12 days (d) received PA only; 30 infants, age 9-92 d received PA c IL and 25 infants, age 8-111 d received formula or breast milk (F/B). Plasma concentrations of glucose (G) triglyceride (TG), free fatty acids (FFA), and FFA composition were determined at weekly intervals during PA infusion; within or>4 hrs of cessation of IL; or immediately before next oral feed. Calorie intake ranged from 60-120 Kcal/Kg.d. PA alone resulted in significantly lower TG, FFA, & essential fatty acids C18:2 & C18:3. 10/21 infants had no detectable C18:2 & C18:3, youngest being age 4 d. TG and FFA were higher in IL infusion group, and assimilation of both TG & FFA were rapid with significant drop occurring 4 hrs post IL infusion. Concl. (1)Provision of essential FA may be necessary within one week for VLBW infants receiving PA alone. (2) Assimilation of IL is enhanced by concurrent PA infusion. This enhancement may be the result of endogenous insulin response to glucose-amino acid infusions.
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