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Published on: September 20, 2019
[Assessment of standard parenteral nutrition in children]
I Caba Porras1, A Cabello Muriel, B Oya Alvarez de Morales
1Complejo Hospitalario de Jaén, Jaén, Spain. icabaporras@yahoo.es
Insights
Standardized parenteral nutrition (PN) solutions effectively meet pediatric nutritional needs, demonstrating adaptability and versatility. Their use simplifies the PN process, enhancing efficiency and patient safety in pediatric care.
Area of Science:
- Pediatric Nutrition
- Parenteral Nutrition (PN) Solutions
- Clinical Nutrition
Context:
- Growing consensus on optimizing nutritional support in pediatrics.
- Limited use of standardized PN solutions in children due to adaptability challenges.
- Development and validation of a range of standard PN solutions for pediatric patients (over 1 year or >10 kg) in 2006.
Purpose:
- To evaluate the utilization and suitability of standardized PN solutions in pediatric patients.
- To assess the frequency of standardized PN prescription based on age, weight, and clinical indication.
- To compare nutrient delivery from individualized PN versus standardized PN and reference guidelines.
Summary:
- Standardized PN was used in 83% of 47 pediatric patients (mean weight 26.6 kg, mean age 6.8 years).
- Nutritional requirements were met within 1-3 days using 1-3 standardized formulas, with minimal modifications (4%).
- Individualized PN in 8 children showed lower caloric intake compared to recommendations.
Impact:
- Standardized PN solutions effectively meet nutritional requirements across various pediatric conditions.
- Demonstrated adaptability and versatility of standardized PN in clinical practice.
- Streamlined the prescription-validation-preparation process, improving overall efficiency and patient safety.
Introduction:
Nowadays, there is a stronger consensus on the proceedings of nutritional support with parenteral nutrition (PN) in paediatrics, the prescription standards, its formulation, elaboration, and nutritional requirements in order to improve the process quality and the patient's safety. The use of standardized PN solutions in children is rare due to the difficulty to adapt them to every pathophysiologic condition. In order to do so, in 2006 we designed and validated a big range of standard solutions for children weighing more than 10 kg or being older than 1 year.
Objective:
To assess the use of standard PN solutions and their suitability in children from January of 2006 until June of 2008: the frequency of prescription of standard solutions by age, weight, and indication, as well as their modifications. We compared the nutrients given by individualized PN solutions versus the recommendations of the Reference Guidelines and standardised PN.
Results:
47 children with a mean weight of 26.6 kg (9-50) and mean age 6.8 years (1-14) received 539 units of PN. Standardized PN (437) were used in 83% of the patients. Their total energy requirements were reached within 1-3 days by using one to three types of formulas. Only 4% (22) of them were modified, with easily feasible changes: volume increase (16), glucose lowering (3), and potassium increase (3). The analysis of the individualized PN in 8 children shows the same trend, with a caloric intake lower than 33% of the recommended one.
Conclusion:
Standardized PN meet the nutritional requirements in most of the patients according to their morbid condition, highlighting their adaptability and versatility. Their use has eased the prescription-validation-preparation circuit and has improved the efficiency of the process.
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