Hyperlactataemia during intravenous feeding in childhood

Abstract

A recently introduced synthetic amino acid preparation, Aminoplex 5, appeared suitable for use in intravenous feeding in childhood because it has a low sodium concentration and high caloric value, achieved by using sorbitol and ethanol. The effects of a 2-hour infusion of Aminoplex 5 at 5 ml or 10 ml/kg per hr on the concentrations of several blood metabolites and hormones were investigated in 8 children. All the children showed a rise in blood lactate concentration (range of increase 0·23 to 6·72 mmol/1.) and lactate/pyruvate ratio (range of increase 2·5 to 18·0) and a small consistent fall in blood acetoacetate concentration. The effects were dose related. Free blood fructose was shown in 7 children after Aminoplex 5, the only exception being a preterm infant. No significant changes were found in plasma insulin or growth hormone concentrations. We suggest that the use of this preparation should be accompanied by frequent estimations of blood lactate or acid-base status.