çok dÜşÜk doğum ağırlıklı bebeklerde enteral L-arjinin eklenmesinin morbidite, mortalite ve bÜyÜme Üzerindeki etkileri

Memişoğlu, Aslı Çınar; Yiğit, Şule; Tekinalp, Gülsevin; Yurdakök, Murat; Korkmaz, Ayşe
January 2009
Cocuk Sagligi ve Hastaliklari Dergisi;oca-mar2009, Vol. 52 Issue 1, p9
Academic Journal
Arginine is an essential amino acid in the fetus and neonate and is a conditionally essential nutrient for adults. As a precursor for the synthesis of nitric oxide (NO) and other molecules that have enormous biologic importance and as a stimulant to the production of growth hormone, L-arginine plays versatile key roles in nutrition, immunodefense and metabolism. The objectives of this study were to investigate whether there is a relationship between morbidity, mortality, and plasma arginine levels, and to determine whether long-term arginine-supplemented enteral nutrition affects morbidity, mortality, hospital stay, and growth parameters in premature infants with birth weight ≤1500 g and gestational age ≤34 weeks. In this placebo-controlled study, 53 preterm infants with a birth weight of ≤1500 g and gestational age ≤34 weeks were prospectively, randomly assigned to receive enterally supplemental L-arginine (250 mg/kg per day, study group; n=27) or sterile water (placebo) (control group; n=26). Nine infants from the study group and nine infants from the control group were lost to follow-up; 18 infants from the study group and 17 infants from the control group completed the study. Blood samples for plasma arginine levels on the 1st and 15th days of life and at the postconceptional 40th week were collected. Growth parameters (weight, length, head circumference, right upper arm mid-circumference and right thigh mid-circumference) were measured on the 1st and 15th days of life and at the postconceptional 40th week. Arginine supplementation was discontinued at the end of the postconceptional 40th week. There were no significant differences in growth parameters on the 15th day and at the postconceptional 40th week between the study and control groups. There was no relationship between plasma arginine levels on the 1st day, 15th day, and at the postconceptional 40th week and either synchronized growth parameters or morbidity and mortality in all infants. There was also no difference between the supplemented group and control group in terms of incidence of morbidity and mortality. We concluded that arginine supplementation by enteral route alone in premature infants does not affect the growth parameters, morbidity or mortality.


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