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 23 November 2017

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News

Arginine supplementation prevents necrotizing enterocolitis in premature infants

Arginine supplementation reduces the incidence of all stages of necrotizing enterocolitis in premature infants, claims a team from Alberta, Canada.

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The researchers determined whether arginine supplementation prevents necrotizing enterocolitis in premature infants, and reported their findings in the latest issue of the Journal of Pediatrics.

A total of 152 infants, with a birth weight ≤ 1250 g and gestational age ≤ 32 weeks, were included in the study.

These were prospectively, randomly assigned to receive either supplemental L-arginine (1.5 mmol/kg per day, n = 75 [Group A]) or placebo (control group, n = 77 [Group B]) with oral feeds/parenteral nutrition during the first 28 days of life.

Nutrient intake, plasma ammonia, arginine, and amino acid concentrations were measured in all infants at days 3, 14, and 28 and at the time of diagnosis of necrotizing enterocolitis.

The team found that necrotizing enterocolitis developed in 5 infants in Group A compared with 21 infants in Group B.

Arginine intake and plasma arginine concentrations were similar in both groups at study entry and (as expected) increased in Group A at days 14 and 28.

Infants that developed necrotizing enterocolitis:
Arginine: 7%
Placebo: 27%
Journal of Pediatrics
Plasma arginine concentrations were found to be lower in both groups at time of diagnosis of necrotizing enterocolitis.

No significant differences in maternal and neonatal demographics, nutrient intake, plasma ammonia, and total and essential amino acid concentrations were present between the 2 groups.

Dr Harish J. Amin, of the University of Calgary, Alberta, concluded on behalf of the group, "Arginine supplementation (1.5 mmol/kg per day) in premature infants reduces the incidence of all stages of necrotizing enterocolitis."

In an accompanying Editorial, Josef Neu, of the University of Florida, USA, comments, "Arginine supplementation has excellent theoretic potential in playing a role in nutrition of the very low birth weight infant.

"However, its specific beneficial roles still need to be determined; they may extend well beyond the prevention of necrotizing enterocolitis."

J Pediatr 2002; 140: 425-31
16 May 2002

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