Amino Acid and Acylcarnitine Profiles in Premature Neonates
How Illness and Nutritional Support Influence Amino Acid and Acylcarnitine Profiles in Premature Neonates
Primary Hypotheses of the study include:
- Metabolic profiles are influenced by gestational age, chronological age, type and degree of nutritional support and illness
- Metabolic profiles differ between neonates who receive commercial formula and neonates who receive primarily human breast milk
- Neonates who develop parenteral associated cholestasis have metabolic markers that identify at risk patients (high serum urea nitrogen, citrulline, histidine, methionine, and succinyl carnitine and low thyroxine, serine and glutamate)
- Neonates that have hypothyroidism have abnormal metabolic profiles (low tyrosine levels)
연구 개요
상세 설명
Malnutrition is a common problem in the neonatal intensive care unit. Recent studies indicate that prematurely born neonates commonly develop a severe nutritional deficit during the first weeks after birth, referred to as extrauterine growth restriction. Despite an increase in growth during the second month of hospitalization, many neonates are ultimately discharged home having grown inadequately. The early nutritional deficit affects weight gain as well as growth in length and head circumference. Aggressive administration of parenteral amino acids to improve protein accretion rates in very preterm neonates has been supported in the literature. Although tolerance of high dose amino acids has been described, researchers acknowledge that sensitive tests to monitor amino acid toxicity are not readily available in the clinical setting.
The goals of this study are:
- To better define normal amino acid and acylcarnitine values and how they change in premature neonates
- To measure the effect nutritional support has (human breastmilk vs. formula) on amino acid and acylcarnitines profiles
- To measure the effect of illness (parenteral nutrition associated cholestasis) on amino acid and acylcarnitine profiles
- To better define abnormal metabolic profiles (low tyrosine levels) in neonates that have hypothyroidism.
연구 유형
등록 (실제)
연락처 및 위치
연구 장소
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Indiana
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South Bend, Indiana, 미국, 46601
- Memorial Hospital South Bend
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South Carolina
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Florence, South Carolina, 미국, 29506
- McLeod Regional Medical Center
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참여기준
자격 기준
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건강한 자원 봉사자를 받아들입니다
연구 대상 성별
샘플링 방법
연구 인구
설명
Inclusion Criteria
- Documentation of informed consent
- Inborn
- Less than or equal to twenty four (24) hours of age
- Gestational age between twenty three (23) weeks and 0/7 days and thirty one (31) weeks and 0/7 days as per the best estimate by the neonatologist
- If subject is transferred to another hospital, the ability to obtain follow-up data on outcomes
- No known major anomalies (inborn error of metabolism, chromosomal abnormalities, cyanotic congenital heart disease, gastroschisis, omphalocele, diaphragmatic hernia or other major gastrointestinal anomalies, major neurological injury or anomaly, and multiple congenital anomalies)
Exclusion Criteria
- Outborn (transferred for intensive care from another hospital)
- Greater than twenty four (24) hours of age
- Gestational age < 23 weeks or > 31 weeks
- Any known major congenital anomalies
공부 계획
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디자인 세부사항
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
기간 |
|---|---|
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Metabolic Profile - Serum amino acid, acylcarnitine and thyroxine levels. Day of birth, (first 24 hours), Day 7, (parenteral nutrition effect), Day 28, (enteral nutrition effect), Day 42, or discharge (established enteral feeding and growth)
기간: 42 Days of Life
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42 Days of Life
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2차 결과 측정
결과 측정 |
기간 |
|---|---|
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Occurrence of any of the following: death, cholestatic liver disease, positive blood or CSF culture, NEC, IVH, or respiratory support at 36 weeks PMA.
기간: 42 Days of Life
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42 Days of Life
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공동 작업자 및 조사자
스폰서
수사관
- 수석 연구원: Reese Clark, MD, Pediatrix Medical Group, Inc.
간행물 및 유용한 링크
일반 간행물
- Clark RH, Chace DH, Spitzer AR. Impact of l-carnitine supplementation on metabolic profiles in premature infants. J Perinatol. 2017 May;37(5):566-571. doi: 10.1038/jp.2016.253. Epub 2017 Jan 12.
- Jacob J, Kamitsuka M, Clark RH, Kelleher AS, Spitzer AR. Etiologies of NICU deaths. Pediatrics. 2015 Jan;135(1):e59-65. doi: 10.1542/peds.2014-2967. Epub 2014 Dec 8. Erratum In: Pediatrics. 2015 Apr;135(4):775-7.
연구 기록 날짜
연구 주요 날짜
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기본 완료 (실제)
연구 완료 (실제)
연구 등록 날짜
최초 제출
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처음 게시됨 (추정)
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추가 정보
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