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A pilot study on the biochemical effects of repeated administration of 24% oral sucrose vs. 30% oral dextrose on urinary markers of adenosine triphosphate degradation

Journal of Perinatology volume 41, pages 2761–2765 (2021)Cite this article

Subjects

Objectives

Premature neonates often receive oral sucrose or dextrose before tissue-damaging procedures (TDPs). Previous work showed that a single dose of sucrose, but not dextrose, increased cellular energy utilization and ATP degradation. This pilot study probes the effects of repeated administration of sucrose or dextrose on energy metabolism.

Methods

Urinary markers of ATP metabolism (hypoxanthine, xanthine, uric acid) are measured in premature neonates randomized to receive: (a) standard of care, (b) 0.2 ml 24% oral sucrose, or (c) 0.2 ml 30% oral dextrose, before every painful procedure on days-of-life 3–7.

Results

Standard of care is associated with highest xanthine/creatinine and uric acid/creatinine, likely because of fewer pain treatments. Benefits of repeated oral sucrose are unclear. Neonates receiving oral dextrose had lower xanthine/creatinine and uric acid/creatinine.

Conclusions

Repeated treatments of neonatal procedural pain with 30% oral dextrose are less energetically demanding. Larger clinical studies are needed for comparison with sucrose treatments.

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Fig. 1: Urinary hypoxanthine/creatinine in premature neonates.
Fig. 2: Urinary xanthine/creatinine in premature neonates.
Fig. 3: Urinary uric acid/creatinine in premature neonates.
Fig. 4: Purine Degradation Scheme.

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Acknowledgements

We thank Yayesh Asmerom MS, for performing all the purine measurements and Desiree Wallace, PharmD, for providing the study drug and assisting with the randomization of subjects. We thank Judy Gates, RN, MS for subject enrollment and Cassia Owen MS for assisting with sample collection and preparation. We also thank the NICU nurses at Loma Linda University Children’s Hospital for their support of this project.

Funding

This work was supported by NIH grant RO1 NR011209 (Angeles).

Author information

Authors and Affiliations

  1. Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA

    Danilyn M. Angeles, Danilo S. Boskovic & Victor Camberos

  2. Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, USA

    Douglas Deming, Andrew Hopper, Ricardo Peverini, Raylene Phillips, John B. Tan, Mitchell Goldstein, Giang Truong & Elba Fayard

  3. Department of Pediatrics, Warren Alpert Medical School, Brown University, Providence, RI, USA

    Adam Czynski

  4. Neonatal Intensive Care Unit, Loma Linda University Children’s Hospital, Loma Linda, CA, USA

    Erin Hoch & Priscilla Pegis

  5. Department of Pharmaceutical and Administrative Sciences, Loma Linda University, Loma Linda, CA, USA

    Khaled Bahjri

Authors
  1. Danilyn M. Angeles
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  2. Danilo S. Boskovic
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  3. Douglas Deming
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  15. Elba Fayard
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Contributions

All authors provided final approval of the submitted final version of the paper. DA designed the experiments, acquired the funding, participated in the analysis and interpretation of the data, wrote the original and final draft, and is accountable for all aspects of the study. DB participated in the interpretation of the data, made substantial contributions to the writing of the paper, and is accountable for all aspects of the study. EF assisted in the design of the study and acquisition of data, participated in the interpretation of the data, made substantial contributions to the paper, and is accountable for all aspects of the study. KB participated in the analysis and interpretation of the data and made substantial contributions to the writing of the paper and is accountable for all aspects of the study. DD, AH, RP, AC, EH, RP, JT, VC, PP, MG, GT participated in the acquisition and interpretation of the data, made substantial contributions to the writing of the paper and are accountable for all aspects of the study.

Corresponding author

Correspondence to Danilyn M. Angeles.

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Angeles, D.M., Boskovic, D.S., Deming, D. et al. A pilot study on the biochemical effects of repeated administration of 24% oral sucrose vs. 30% oral dextrose on urinary markers of adenosine triphosphate degradation. J Perinatol 41, 2761–2765 (2021). https://doi.org/10.1038/s41372-021-01239-8

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