Hvor mye proteintilskudd bør premature barn få, er serum-urea en god markør for å evaluere proteinbelastning og hvor høye verdier kan vi tillate?

There is a broad consensus that premature children need protein supplements to improve growth and reduce protein loss in the first days of life, but there is a lack of clear guidelines for when to start supplementation after birth and which amount of protein that should be administered. The goal of our student master thesis was to explore the optimal amount of protein supplement for premature children and if serum urea measurements, or BUN (Blood Urea Nitrogen), could be used to indicate how much protein each child should receive. We wanted to determine if serum or blood urea measurements are useful, and if so, how high urea values could be accepted in each individual. We wanted to understand potential side effects of high levels of urea in the blood. As it appears, serum urea is a good marker that tells you how the protein is processed and tolerated in the body of a premature child, but not at the very beginning of life. The first weeks of life, depending on gestational age and weight, the urea values will be affected by many factors. High urea values may be present without necessarily causing any harm. Regarding how many grams of protein one should give per kg body weight, the numbers used in the different studies are quite similar. We have not managed to conclude which values should be used as national guidelines, but in the literature, we found that protein supplementation can likely be optimized further than what is current practice.