The Standardised, Concentrated with Added Macronutrients Parenteral (SCAMP) nutrition regimen is a method of hyperalimentation for very preterm infants (VPI). Current neonatal parenteral nutrition (PN) amino acid (AA) formulations predate recent recommended protein intakes. Tyrosine, cysteine, glutamine, arginine and proline are considered conditionally essential AA (CEAA) in VPI due to inadequate metabolic pathways. We hypothesised hyperalimentation would prevent low plasma levels of CEAA.Methods
Control PN was started within 6 h of birth and infants (<1200g; <29 weeks) were randomised to start SCAMP or remain on control. Plasma AA levels were measured weekly in PN-dependent infants by ion-exchange chromatography.Results
Infants were randomised to SCAMP (n = 74) and control (n = 76) groups. All plasma essential AAs were at the upper limit/above the reference range (RR) in both groups (data not shown). Plasma arginine/cysteine levels (week 2) and cysteine levels (week 3) were below RR in both groups (Table 1). Only plasma proline levels were higher than RR.Conclusion
Despite hyperalimentation, PN-dependent VPI remain biochemically deficient in some conditionally essential AAs.