Plasma amino acid (AA) concentrations were analyzed using ion exchange chromotography in 15 children aged 4-65 months who received total parenteral nutrition (TPN) as their only source of nutrition (7 pts, Gp I) or who ingested 30-70% of their total energy requirements orally and received the remainder intravenously (8 pts, Gp II). The pts in Gps I and II received TPN for 25.6±14.4 SD and 25.7±19.1 months, respectively. All pts in Gp I and 4 in Gp II had short bowel syndrome (SBS); 4 in Gp II had pseudoob-struction syndrome. Gp I had decreased plasma concentrations of total essential AA, branched chain AA, the semi-essential AA (cysteine and tyrosine) and the urea cycle AA. Gp II children had notably decreased plasma concentrations of branched chain AA and tyrosine. Both gps had significantly increased concentrations of glycine and decreased concentrations of taurine. The children with cholestatic liver disease had the lowest plasma concentrations of the branched chain AA. The plasma concentrations of the individual AA in the children reflected the composition of the AA given in the TPN solutions (Travasol® 8.5%), indicating that children receiving long term TPN will develop abnormalities in their plasma AA concentrations despite receiving adequate amounts of AA in their TPN solutions. This condition could be explained by the unbalanced AA solutions the children received, but other factors that could interfere with their AA metabolism were significant liver disease and SBS with minimal enteral intake.
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Dahlstrom, A., Ament, M., Laidlaw, S. et al. PLASMA AMINO ACID CONCENTRATIONS IN CHILDREN RECEIVING LONG TERM TOTAL PARENTERAL NUTRITION. Pediatr Res 21, 266 (1987). https://doi.org/10.1203/00006450-198704010-00595