RESUMEN
OBJECTIVE: The aim of the study was to evaluate the effect on growth and neurodevelopment of increasing amino acid (AA) during parenteral nutrition and protein intake during enteral nutrition in extremely low birth-weight infants starting from birth to day of reaching 1800âg body weight. METHODS: We randomized preterm infants with birth weight 500 to 1249âg either to a high AA/protein intake (HiP [high protein]: parenteral nutritionâ=â3.5âAA, enteral nutritionâ=â4.6 protein gâ·âkgâ·âday) or to a standard of care group (StP [standard protein]: parenteral nutritionâ=â2.5âAA, enteral nutritionâ=â3.6 protein gâ·âkgâ·âday). The primary outcome was weight gain from birth to 1800âg. RESULTS: TWO:: hundred twenty-six patients were screened, 164 completed the study and were analyzed (82 StP and 82 HiP). Cumulative AA/protein intake from birth to 1800âg was 178â±â42 versus 223â±â45âg/kg in the StP versus HiP group respectively, Pâ<â0.0001.Blood urea was higher in HiP than in StP group both during parenteral and enteral nutrition (Pâ=â0.004).Weight gain from birth to 1800âg was 12.3â±â1.6 in StP and 12.6â±â1.7âgâ·âkgâ·âday in HiP group (Pâ=â0.294). We found no difference in any growth parameters neither during hospital stay nor at 2 years corrected age. Bayley III score at 24 months corrected age was 93.8â±â12.9 in StP group and 94.0â±â13.9 in the HiP group, Pâ=â0.92. CONCLUSIONS: Increasing AA/protein intake both during parenteral and enteral nutrition does not improve growth and neurodevelopment of small preterm infants 500 to 1249âg birth weight.