A Piglet Model for Neonatal Amino Acid Metabolism During Total Parenteral Nutrition

  • Ronald O. Ball
  • James D. House
  • Linda J. Wykes
  • Paul B. Pencharz
Chapter

Abstract

Premature birth is a leading cause of infant morbidity and mortality. An important factor in the care of these neonates is the establishment of appropriate nutritional strategies. Low birth weight (LBW) infants often have an inability to tolerate oral feedings, due to a variety of factors, including short bowel syndrome, gastrointestinal surgery, chronic severe diarrhea, immature bowel function1 and respiratory diseases.2 In these instances, the provision of nutrition by parenteral means is necessary. Total parenteral nutrition (TPN) involves the infusion of amino acids, glucose, lipid, vitamins and minerals directly into the venous circulation. As with all neonatal nutrition regimens, the aim in providing TPN to LBW infants is to promote the growth of the infant, without imposing undue stresses on metabolic pathways or creating adverse long term outcomes.

Keywords

Total Parenteral Nutrition Total Amino Acid Amino Acid Profile Nitrogen Retention Amino Acid Requirement 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Hay, W.W., Jr., 1986, Justification for total parenteral nutrition in the premature and compromised newborn, in: Total Parenteral Nutrition: Indications, Utilization, Complications, and Pathophysiological Considerations (E. Lebenthal, ed.), Raven Press, New York, pp. 277–304.Google Scholar
  2. 2.
    Adamkin, D.H., 1986, Total parenteral nutrition in hyaline membrane disease, in: Total Parenteral Nutrition: Indications, Utilization, Complications, and Pathophysiological Considerations (E. Lebenthal, ed.), Raven Press, New York, pp. 305–318.Google Scholar
  3. 3.
    Dudrick, S.J., Wilmore, D.W., Vars, H.M., and Rhoads, J.E., 1968, Longterm total parenteral nutrition with growth, development and positive nitrogen balance, Surgery 64:134–142.PubMedGoogle Scholar
  4. 4.
    Heird, W.C., 1972, Intravenous alimentation in pediatric patients, J. Pediatr. 80:351–372.PubMedCrossRefGoogle Scholar
  5. 5.
    Wykes, L.J., Ball, R.O., Menendez, C.E., Malyon Ginther, D., and Pencharz, P.B., 1992, Glycine, leucine and phenylalanine flux in low-birth-weight infants during parenteral and enteral feeding, Am. J. Clin. Nutr. 55:971–975.PubMedGoogle Scholar
  6. 6.
    Atkinson, S.A., and Hanning, R.M., 1989, Amino acid metabolism and requirements of the premature infant: Is human milk the “gold standard”?, in: Protein and Non-protein Nitrogen in Human Milk (S.A. Atkinson, and B. Lonnerdal, eds.), CRC Press, Boca Raton, pp. 187–209.Google Scholar
  7. 7.
    Medical Research Council of Canada, 1987, Guidelines on research involving human subjects, Ministry of Supply and Services, Ottawa, pp. 29–30.Google Scholar
  8. 8.
    Book, S.A., and Bustad, L.K., 1974, The fetal and neonatal pig in biomedical research, J. Anim. Sci. 38:997–1002.PubMedGoogle Scholar
  9. 9.
    Pond, W.G. and Houpt, K.A., 1978, The Biology of the Pig, Cornell University Press, Ithaca.Google Scholar
  10. 10.
    Miller, E.R., and Ullrey, D.E., 1987, The pig as a model for human nutrition, Ann. Rev. Nutr. 7:361–382.CrossRefGoogle Scholar
  11. 11.
    Moughan, P.J., and Rowan, A.M., 1989, The pig as a model animal for human nutrition research, Proc. Nutr. Soc. New Zealand 14:116–123.Google Scholar
  12. 12.
    Shulman, R.J., Henning, S.J., and Nichols, B.L., 1988, The miniature pig as an animal model for the study of intestinal enzyme development, Pediatr. Res. 23:311–315.PubMedCrossRefGoogle Scholar
  13. 13.
    Terris, J.M., 1986, Swine as a model in renal physiology and nephrology: an overview, in: Swine in Biomedical Research, Volume 1 (M.E. Tumbleson, ed.), Plenum Press, New York, pp. 1673–1689.Google Scholar
  14. 14.
    Glauser, E.M., 1966, Advantages of piglets as experimental animals in pediatric research, Exp. Med. Surg. 24:181–190.PubMedGoogle Scholar
  15. 15.
    Shulman, R.J., 1993, The piglet can be used to study the effects of parenteral and enteral nutrition on body composition, J. Nutr. 123:395–398.PubMedGoogle Scholar
  16. 16.
    Dobbing, J., and Sands, J., 1979, Comparative aspects of the brain growth spurt, Early Hum. Dev. 3:79–83.PubMedCrossRefGoogle Scholar
  17. 17.
    Purvis, J.M., Clandinin, M.T., and Hacker, R.R., 1982, Fatty acid accretion during perinatal brain growth in the pig. A model for fatty acid accretion in the human brain, Comp. Biochem. Biophys. [B] 72:195–199.Google Scholar
  18. 18.
    Rossi, T.M., 1986, Effects of total parenteral nutrition on the digestive organs, in: Total Parenteral Nutrition: Indications, Utilization, Complications and Pathophysiological Considerations (E. Lebenthal, ed.), Raven Press, New York, pp. 173–184.Google Scholar
  19. 19.
    Adeola, O., Wykes, L.J., Ball, R.O., and Pencharz, P.B., 1995, Comparison of oral milk feeding and total parenteral nutrition in neonatal pigs, Nutr. Res. 15:245–265.CrossRefGoogle Scholar
  20. 20.
    Burrin, D.G., Shulman, R.J., Storm, M.C., and Reeds, P.J., 1991, Glutamine or glutamic acid effects on intestinal growth and disaccharidase activity in infant piglets receiving total parenteral nutrition. J. Parent. Ent. Nutr. 15:262–266.CrossRefGoogle Scholar
  21. 21.
    Mount, L.E., and Ingram, D.L., 1971, The pig as a laboratory animal. Academic Press, London.Google Scholar
  22. 22.
    Pencharz, P.B., Parson, H., Motil, K., and Duffy, B., 1981, Total body protein turnover in children: Is it a futile cycle?, Med. Hypoth. 7:155–160.CrossRefGoogle Scholar
  23. 23.
    Mulvaney, D.R., Merkel, R.A., and Bergen, W.G., 1985, Skeletal muscle protein turnover in young male pigs, J. Nutr. 115:1057–1064.PubMedGoogle Scholar
  24. 24.
    Reeds, P.J. and Harris, C.I., 1981, Protein turnover in animals: man in his context, in: Nitrogen metabolism in man (J.C. Waterlow, and J.M. Stephen, eds.), Applied Science, London, pp. 391–408.Google Scholar
  25. 25.
    Benevenga, N.J., 1986, Amino acid metabolism in swine: Applicability to normal and altered amino acid metabolism in humans, in: Swine in Biomedical Research, Volume 2 (M.E. Tumbleson, ed.), Plenum Press, New York, pp. 1017–1030.Google Scholar
  26. 26.
    Waterlow, J.C., Garlick, P.J., and Millward, D.J., 1987, Protein Turnover in Mammaliam Tissues and in the Whole Body, North Holland, Amsterdam.Google Scholar
  27. 27.
    Wu, P.Y.K., Edward, N.B., and Storm, M.C., 1986, The plasma amino acid pattern of normal term breast-fed infants, J. Pediatr. 109:347–349.PubMedCrossRefGoogle Scholar
  28. 28.
    Hagemeier, D.L., Libal, G.W., and Wahlstrom, R.C., 1983, Effects of excess arginine on swine growth and plasma amino acid levels, J. Anim. Sci. 57:99–105.PubMedGoogle Scholar
  29. 29.
    Borum, P.R., 1990, The colostrum-deprived TPN piglets as a model to evaluate the effect of different amino acid formulations on neonatal metabolism, FASEB J. 4:A507.Google Scholar
  30. 30.
    House, J.D., Pencharz, P.B., and Ball, R.O., 1994, Glutamine supplementation to total parenteral nutrition promotes extracellular fluid expansion in piglets, J. Nutr. 124:396–405.PubMedGoogle Scholar
  31. 31.
    National Research Council, 1988, Nutrient Requirements of Swine, Ninth revised ed., National Academy Press, Washington, D.C.Google Scholar
  32. 32.
    FAO/WHO Expert Consultation, 1990, Protein Quality Evaluation, WHO, Rome.Google Scholar
  33. 33.
    FAO/WHO/UNU Expert Consultation, 1985, Energy and Protein Requirements, (WHO Technical Report Series No 724) WHO, Geneva.Google Scholar
  34. 34.
    Fuller, M.F., McWilliam, R., Wang, T.C., and Giles, L.R. 1989, The optimum dietary amino acid pattern for growing pigs, Br. J. Nutr. 62:255–267.PubMedCrossRefGoogle Scholar
  35. 35.
    Widdowson, E.M., 1979, Body composition of the fetus and infant, in: Nutrition and Metabolism of the Fetus and Infant, Fifth Nutricia Symposium (H.K.A. Visser, ed.), Martinus Nijhoff, The Hague, pp. 147–157.Google Scholar
  36. 36.
    Widdowson, E.M., 1968, Growth and composition of the fetus and newborn, in: Biology of Gestation, (N.S. Assasli, ed.) Academic Press, New York, pp. 1–49.Google Scholar
  37. 37.
    Pond, W.G., Ellis, K.J., and Schoknecht, P., 1992, Response of blood serum constituents to production of and recovery from a kwashiorkor-like syndrome in the young pig, Proc. Soc. Exp. Biol. Med. 200:555–561.PubMedGoogle Scholar
  38. 38.
    Newport, M.J., and Henschel, M.J., 1984, Evaluation of the neonatal pig as a model for infant nutrition: effects of different proportions of caesin and whey protein in milk on nitrogen metabolism and composition of digesta in the stomach, Pediatr. Res. 18:658–662.PubMedCrossRefGoogle Scholar
  39. 39.
    Hrboticky, N., MacKinnon, M.J., and Innis, S.M., 1990, Effect of a vegetable oil formula rich in linoleic acid on tissue fatty acid accretion in the brain, liver, plasma and erythrocytes of infant piglets, Am. J. Clin. Nutr. 51:173–182.PubMedGoogle Scholar
  40. 40.
    Odle, J., Benevenga, N.J., and Crenshaw, T.D., 1991, Utilization of medium-chain triglycerides by neonatal piglets: chain length of even-and odd-carbon fatty acids and apparent digestion/absorption and hepatic metabolism, J. Nutr. 121:605–614.PubMedGoogle Scholar
  41. 41.
    Arbuckle, L.D., and Innis, S.M., 1992, Docosahexaenoic acid in developing brain and retina of piglets fed high or low w-linolenate formula with and without fish oil, Lipids, 27:89–93.PubMedCrossRefGoogle Scholar
  42. 42.
    Morgan III, W., Yardley, J., Luk, G., Niemiec, P., and Dudgeon, D., 1987, Total parenteral nutrition and intestinal development: a neonatal model, J. Pediatr. Surg. 22:541–545.PubMedCrossRefGoogle Scholar
  43. 43.
    Groner, J.I., Altschuler, S.M., and Ziegler, T.R., 1990, The newborn piglet: a model of neonatal gastrointestinal mobility, J. Pediatr. Surg. 25:315–318.PubMedCrossRefGoogle Scholar
  44. 44.
    Cohen, I.T., Nelson, S.D., Moxley, R.A., Hirch, M.P., Counihan, T.C., and Martin, R.F., 1991, Necrotizing enterocolitis in a neonatal piglet model, J. Pediatr. Surg. 26:598–601.PubMedCrossRefGoogle Scholar
  45. 45.
    Draper, H.H., Yuen, D.E., and Whyte, R.K., 1991, Calcium lycerophosphate as a source of calcium and phosphorus in total parenteral nutrition solutions, J. Parent. Ent. Nutr. 15:176–180.CrossRefGoogle Scholar
  46. 46.
    Shulman, R.J., Fiorotto, M.L., Sheng, H-P, and Garza, C., 1984, Effect of different total parenteral nutrition fuel mixes on the body composition of infant miniature pigs, Pediatr. Res. 18:261–265.PubMedCrossRefGoogle Scholar
  47. 47.
    Fiorotto, M.L., Shulman, R.J., Sheng, H-P, and Garza, C., 1986, The effects of different total parenteral nutrition fuel mixes on skeletal muscle composition of infant miniature pigs, Metabolism 35:354–359.PubMedCrossRefGoogle Scholar
  48. 48.
    Shulman, R.J., Fiorotto, M.L., Sheng, H-P, Finegold, M.J., and Garza, C., 1987 Liver composition and histology in growing infant miniature pigs given different total parenteral nutrition fuel mixes, J. Pediat. Gastroenterol. Nutr. 11:275–279.Google Scholar
  49. 49.
    Shulman, R.J., and Burrin, D.G., 1991, Total parenteral nutrition energy composition affects small intestinal disaccharidase activity in the newborn miniature pig, J. Parent. Ent. Nutr. 15:560–563.CrossRefGoogle Scholar
  50. 50.
    Cohen, I.T., Meunier, K.M., and Hirsh, M.P., 1990, The effects of enteral stimulation on gallbladder bile during total parenteral nutrition in the neonatal piglet, J. Pediatr. Surg. 25:163–167.PubMedCrossRefGoogle Scholar
  51. 51.
    Van Aerde, J., Higa, T., Chan, G., Feldman, M., Lemke, R., and Clandinin, M., 1990, Eicosapentanoic (EPA) and docosahexanoic (DHA) acid prevent cholestatic jaundice in the intravenously fed neonate. FASEB J. 4:A507.Google Scholar
  52. 52.
    Remillard, R., Yardley, J., Mitchell, K., Fuerino, F., and Dudgeon, D., 1992, Oral feeding effects in reversing total parenteral nutrition-induced small bowel atrophy in neonatal piglets, FASEB J. 6:A1113.Google Scholar
  53. 53.
    Burrin, D.G., Shulman, R.J., Storm, M.C., and Reeds, P.J., 1991, Glutamine or glutamic acid effects on intestinal growth and disaccharidase activity in infant piglets receiving total parenteral nutrition, J. Parent. Ent. Nutr. 15:262–266.CrossRefGoogle Scholar
  54. 54.
    Guerino, F., Yardley, J.H., and Dudgeon, D.L., 1991, Effects of total parenteral nutrition (TPN) with IV glutamine or limited enteral feeding on development of the neonatal piglet intestinal tract, FASEB J. 5:A1451.Google Scholar
  55. 55.
    Shulman, R.J., 1988, Effect of different total parenteral nutrition fuel mixes on small intestinal growth and differentiation in the infant miniature pig, Gastroenterol. 95:85–92.Google Scholar
  56. 56.
    Goldstein, R.M., Hebiguchi, T., Luk, G.D., Taqi, F., Guilarte, T.R., Franklin, F.A., Niemiec, P.W., and Dudgeon, D.L., 1985, The effects of total parenteral nutrition on gastrointestinal growth and development, J. Pediatr. Surg. 20:785–791.PubMedCrossRefGoogle Scholar
  57. 57.
    Mehrazar, K., and Kim, Y.B., 1988, Total parenteral nutrition in germ-free colostrum-deprived neonatal miniature piglets: a unique model to study the ontogeny of the immune system, J. Parent. Ent. Nutr. 12:563–568.CrossRefGoogle Scholar
  58. 58.
    Wykes, L.J., Ball, R.O., and Pencharz, P.B., 1993, The development and validation of a total parenteral nutrition model in the neonatal piglet, J. Nutr. 123:1248–1259PubMedGoogle Scholar
  59. 59.
    Wykes, L.J., House, J.D., Ball, R.O., and Pencharz, P.B., 1994, Amino acid profile and aromatic amino acid concentration in total parenteral nutrition: effect on growth, protein metabolism and aromatic amino acid metabolism in the neonatal piglet, Clin. Sci. 87:75–84.PubMedGoogle Scholar
  60. 60.
    Wykes, L.J., House, J.D., Ball, R.O., and Pencharz, P.B., 1994, Aromatic amino acid metabolism of neonatal piglets receiving TPN: effect of tyrosine precursors, Am. J. Physiol. 267:E672–E679.PubMedGoogle Scholar
  61. 61.
    Ball, R.O., and Bayley, H.S., 1985, Time course of evolution of total and 14C-labelled carbon dioxide by young pigs receiving diets containing 14C-phenylalanine, Can. J. Physiol. Pharmacol. 63:1170–1174.PubMedCrossRefGoogle Scholar
  62. 62.
    Puntis, J.W.L., Edwards, M.A., Green, A., Morgan, I., Booth, I.W., and Ball, P.A., 1986, Hyperpheny-lalanaemia in parenterally fed newborn babies, Lancet ii: 1105–1106.CrossRefGoogle Scholar
  63. 63.
    Walker, V.A., Hall, M.A., Bulusu, S., and Allan, A., 1986, Hyperphenylalanaemia in parenterally fed newborn babies, Lancet ii: 1284.CrossRefGoogle Scholar
  64. 64.
    Zello, G.A., Wykes, L.J., Ball, R.O., and Pencharz, P.B., 1995, Recent advances in methods of assessing dietary amino acid requirements for adult humans, J. Nutr. 125: 2907–2915.PubMedGoogle Scholar
  65. 65.
    Kim, K.I., McMillan, I., and Bayley, H.S., 1983, Determination of amino acid requirements of young pigs using an indicator amino acid, Br. J. Nutr. 50:369–382.PubMedCrossRefGoogle Scholar
  66. 66.
    Ball, R.O., and Bayley, H.S., 1984, Tryptophan requirement of the 2.5-kg piglet determined by the oxidation of an indicator amino acid, J. Nutr. 114:1741–1746.PubMedGoogle Scholar
  67. 67.
    Zello, G.A., Pencharz, P.B., and Ball, R.O., 1993, The dietary lysine requirement of young adult males determined by the oxidation of an indicator amino acid, L-[ 1 13C]phenylalanine, Am. J. Physiol. 264:E677–E685.PubMedGoogle Scholar
  68. 68.
    Kim, K.I., and Bayley, H.S., 1983, Amino acid oxidation by young pigs receiving diets with varying levels of sulphur amino acids, Br. J. Nutr. 50:383–390.PubMedCrossRefGoogle Scholar
  69. 69.
    Kim, K.I., Elliott, J.I., and Bayley, H.S., 1983, Oxidation of an indicator amino acid by young pigs receiving diets with varying levels of lysine or threonine, and an assessment of amino acid requirements, Br. J. Nutr. 50:391–399.PubMedCrossRefGoogle Scholar
  70. 70.
    Ball, R.O., Atkinson, J.L., and Bayley, H.S., 1986, Proline as an essential amino acid for the young pig, Br. J. Nutr. 55:659–668.PubMedCrossRefGoogle Scholar
  71. 71.
    Lazaris-Brunner, G., Pencharz, P.B., and Ball, R.O., 1994, Tryptophan requirement of young women determined by indicator amino acid oxidation, FASEB J. 8:A462.Google Scholar
  72. 72.
    Duncan, A.M., Pencharz, P.B., and Ball, R.O., 1995, Lysine requirement of adult males using indicator amino acid oxidation. The effect of a lower protein intake, FASEB J. 9.A865.Google Scholar
  73. 73.
    Davis, T.A., Nguyen, H.V., Garcia-Bravo, R., Fiorotto, M., Jackson, E.M., Lewis, D.S., Lee, D.R., and Reeds, P.J., 1994, Amino acid composition of human milk is not unique, J. Nutr. 124:1126–1132.PubMedGoogle Scholar
  74. 74.
    Aumaitre, A., and Duee, P.H., 1974, Composition en acides amines des proteines corporelies du porcelet entre la naissance et Tage de huit semaines, Ann. Zootech. 23:231–236.CrossRefGoogle Scholar
  75. 75.
    Chung, T.K., and Baker, D.H., 1992, Ideal amino acid pattern for 10-kilogram pigs, J. Anim. Sci. 70:3102–3111.PubMedGoogle Scholar
  76. 76.
    Wang, T.C., and Fuller, M.F., 1989, The optimum dietary amino acid pattern for growing pigs. I. Experiments by amino acid deletion, Br. J. Nutr. 62:77–89.PubMedCrossRefGoogle Scholar
  77. 77.
    House, J.D., 1995, The determination of amino acid requirements in neonatal piglets receiving total parenteral nutrition, Ph.D. Thesis, University of Guelph, Guelph, Ontario, Canada.Google Scholar

Copyright information

© Springer Science+Business Media New York 1996

Authors and Affiliations

  • Ronald O. Ball
    • 1
    • 2
    • 3
  • James D. House
    • 1
    • 5
  • Linda J. Wykes
    • 6
  • Paul B. Pencharz
    • 1
    • 3
    • 4
    • 5
  1. 1.Animal and Poultry SciencesUniversity of GuelphGuelphCanada
  2. 2.Human Biology and Nutritional SciencesUniversity of GuelphGuelphCanadaN1G 2W1
  3. 3.Nutritional SciencesUniversity of TorontoCanada
  4. 4.PaediatricsUniversity of TorontoCanada
  5. 5.Hospital for Sick ChildrenTorontoCanada
  6. 6.School of Dietetics and Human NutritionMcGill UniversityQuebecCanada

Personalised recommendations