Plasma ammonia concentrations in extremely low birthweight infants in the first week after birth: secondary analysis from the ProVIDe randomized clinical trial.


Journal

Pediatric research
ISSN: 1530-0447
Titre abrégé: Pediatr Res
Pays: United States
ID NLM: 0100714

Informations de publication

Date de publication:
08 2020
Historique:
received: 30 09 2019
accepted: 09 12 2019
revised: 20 11 2019
pubmed: 3 1 2020
medline: 24 8 2021
entrez: 3 1 2020
Statut: ppublish

Résumé

Little is known about normative ammonia concentrations in extremely low birthweight (ELBW) babies and whether these vary with birth characteristics. We aimed to determine ammonia concentrations in ELBW babies in the first week after birth and relationships with neonatal characteristics and protein intake. Arterial blood samples for the measurement of plasma ammonia concentration were collected within 7 days of birth from ProVIDe trial participants in six New Zealand neonatal intensive care units. Three hundred and twenty-two babies were included. Median (range) gestational age was 25.7 (22.7-31.6) weeks. Median (interquartile range (IQR)) ammonia concentration was 102 (80-131) µg/dL. There were no statistically significant associations between ammonia concentrations and birthweight or sex. Ammonia concentrations were weakly correlated with mean total (Spearman's r Plasma ammonia concentrations in ELBW babies are similar to those of larger and more mature babies and only weakly correlated with protein intake. Currently, recommended thresholds for investigation of hyperammonaemia are appropriate for ELBW babies. Protein intake should not be limited by concerns about potential hyperammonaemia.

Sections du résumé

BACKGROUND
Little is known about normative ammonia concentrations in extremely low birthweight (ELBW) babies and whether these vary with birth characteristics. We aimed to determine ammonia concentrations in ELBW babies in the first week after birth and relationships with neonatal characteristics and protein intake.
METHODS
Arterial blood samples for the measurement of plasma ammonia concentration were collected within 7 days of birth from ProVIDe trial participants in six New Zealand neonatal intensive care units.
RESULTS
Three hundred and twenty-two babies were included. Median (range) gestational age was 25.7 (22.7-31.6) weeks. Median (interquartile range (IQR)) ammonia concentration was 102 (80-131) µg/dL. There were no statistically significant associations between ammonia concentrations and birthweight or sex. Ammonia concentrations were weakly correlated with mean total (Spearman's r
CONCLUSIONS
Plasma ammonia concentrations in ELBW babies are similar to those of larger and more mature babies and only weakly correlated with protein intake. Currently, recommended thresholds for investigation of hyperammonaemia are appropriate for ELBW babies. Protein intake should not be limited by concerns about potential hyperammonaemia.

Identifiants

pubmed: 31896121
doi: 10.1038/s41390-019-0730-z
pii: 10.1038/s41390-019-0730-z
pmc: PMC7384986
doi:

Substances chimiques

Ammonia 7664-41-7

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

250-256

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Auteurs

Barbara E Cormack (BE)

Liggins Institute, University of Auckland, Auckland, New Zealand.
Newborn Services, Auckland City Hospital, Auckland, New Zealand.

Yannan Jiang (Y)

Liggins Institute, University of Auckland, Auckland, New Zealand.

Jane E Harding (JE)

Liggins Institute, University of Auckland, Auckland, New Zealand.

Caroline A Crowther (CA)

Liggins Institute, University of Auckland, Auckland, New Zealand.

Adrienne Lynn (A)

Neonatal Intensive Care Unit, Christchurch Women's Hospital, Christchurch, New Zealand.

Arun Nair (A)

Newborn Intensive Care Unit, Waikato Hospital, Hamilton, New Zealand.

Michael Hewson (M)

Neonatal Intensive Care Unit, Wellington Hospital, Wellington, New Zealand.

Mike Meyer (M)

Neonatal Unit, Middlemore Hospital, Auckland, New Zealand.

Roland Broadbent (R)

Neonatal Intensive Care Unit, Dunedin Hospital, Dunedin, New Zealand.

Dianne Webster (D)

LabPlus, Auckland District Health Board, Auckland, New Zealand.

Emma Glamuzina (E)

National Adult and Paediatric Metabolic Service, Auckland, New Zealand.

Bryony Ryder (B)

National Adult and Paediatric Metabolic Service, Auckland, New Zealand.

Frank H Bloomfield (FH)

Liggins Institute, University of Auckland, Auckland, New Zealand. f.bloomfield@auckland.ac.nz.
Newborn Services, Auckland City Hospital, Auckland, New Zealand. f.bloomfield@auckland.ac.nz.

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Classifications MeSH