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Published on: September 20, 2019
Current use of parenteral nutrition in a pediatric hospital. Comparison to the practise 8 years ago
J M Moreno Villares1, F Fernández Carrión, J I Sánchez Díaz
1Nutrition Unit, Hospital Universitario 12 de Octubre, Madrid, Spain. jmoreno.hdoc@salud.madrid.org
Insights
Parenteral nutrition (PN) use in critically ill children and premature newborns remained largely unchanged over a decade. Key indications included gastrointestinal surgery and extreme prematurity, with few shifts in PN profiles.
Area of Science:
- Pediatric critical care medicine
- Neonatology
- Nutritional support
Background:
- Parenteral nutrition (PN) is vital for critically ill children and extremely premature newborns.
- Understanding trends in pediatric PN is crucial for optimizing patient care.
Purpose of the Study:
- To analyze changes in the profile and utilization of pediatric parenteral nutrition over a ten-year period.
- To identify shifts in indications, composition, and complications of PN in a pediatric institution.
Main Methods:
- Retrospective review of clinical records for pediatric patients (<16 years) receiving PN in 1994 and 2002.
- Data collected included epidemiological factors and PN solution composition.
- Statistical analysis using Student t-test and Chi-square for comparisons.
Main Results:
- Patient numbers receiving PN showed a decrease in neonates but a slight increase in infants/children.
- Gastrointestinal surgery and extreme prematurity were the primary indications for PN.
- Tailored PN for neonates and standardized PN for children were common; vascular access methods varied by age group.
- Complications were reported in 21% of children receiving PN.
Conclusions:
- Pediatric parenteral nutrition practices showed minimal changes over the decade studied.
- Indications for PN remained consistent, primarily gastrointestinal surgery and prematurity.
- Further analysis may be needed to identify areas for improvement in PN delivery and complication reduction.
Unlabelled:
Parenteral nutrition (PN) has become a mainstay in the treatment of critically ill children, and in the management of extremely premature newborns. We analyse the changes in the profile of pediatric PN in our institution during the last decade.
Method:
The clinical record of all patients under 16 who received PN in 1994 and 2002 were reviewed. Epidemiological data as well as composition of the solutions were recorded. Student t test and Chi-square were used for comparisons as appropriate. p value < 0.05 was considered as statistically significant.
Results:
194 patients received PN in 1994 (123 neonates and 71 children); 186 in 2002 (112 neonates and 74 children). The percentage of inpatients who received PN was 10.7% in 1994 vs 3.7% in 2002 in neonates; 1% in 1994 vs 1.3% in 2002, in infants and children. Gastrointestinal surgery in infants and children and extreme prematurity in newborns were the most frequent indication. All neonates received tailored PN solutions while it was standardised in almost 60% of children. Internal jugular vein in children and peripherally inserted central venous catheters in neonates were the most usual vascular access. Length of PN was 10 +/- 8.7 days in 1994 vs 9.2 +/- 8.2 in 2002 in neonates; 15.2 +/- 14.8 days in 1994 vs 11.0 +/- 14.9 in 2002 in infants and children. 21% of the children presented at least one complication due to PN.
Conclusions:
There have been very few changes in the use as well as in the profile of the PN practise during the last decade. Gastrointestinal surgery and prematurity were the most frequent indications.
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