When an ELBW neonate is on Amino acid infusion what is the upper limit of blood Urea that must be considered before stopping or reducing the amino acid infusion

Difficult question/answer.

In general I'd reduce infusion rates of serum urea exceeds above 10 (or perhaps max 12.5) mmol/L. Please take notion on correct conversion, cause this may sometime introduce errors.

But before simply adjusting infusion rates, also assess others causes. Did you provide sufficient concomitant energy (minimal 35 kcal/g animo acids) and electrolytes (esp sufficient phosphate and potassium), and what is fluid status and kidney function?