Improved weight gain in very-low-birth-weight infants after the introduction of a self-created computer calculation
Maria Gnigler1, Bernhard Schlenz1, Ursula Kiechl-Kohlendorfer1
1Department of Pediatrics II (Neonatology), Innsbruck Medical University, Innsbruck, Austria.
Insights
A computer calculation program (CCP) improved nutritional intake in very-low-birth-weight (VLBW) infants. This led to more appropriate for gestational age infants at discharge and better weight gain, supporting CCP use in VLBW infant parenteral nutrition.
Area of Science:
- Neonatal nutrition
- Pediatric gastroenterology
- Clinical informatics
Background:
- Very-low-birth-weight (VLBW) infants often experience nutritional deficiencies, leading to being small for gestational age by 36 weeks.
- A computer calculation program (CCP) was developed to optimize parenteral nutrition (PN) for preterm infants.
Purpose of the Study:
- To evaluate the impact of a CCP on nutritional intake and growth outcomes in VLBW infants.
- To compare growth parameters and PN composition before and after CCP implementation.
Main Methods:
- Retrospective analysis of somatometric data and PN composition in VLBW infants.
- Comparison of two cohorts: pre-CCP (2001-2002) and post-CCP (2004-2005) implementation.
Main Results:
- The post-CCP group showed a significantly higher proportion of appropriate for gestational age (AGA) infants at hospital discharge (44% vs. 14%).
- Increased administration of protein and fat in the first 5 days of life was observed in the CCP group.
- The duration of total PN was significantly shorter in infants managed with the CCP (16 days vs. 24 days).
Conclusions:
- The CCP simplifies PN calculation and contributes to improved weight gain in VLBW infants.
- The study suggests the routine use of the CCP for calculating PN in VLBW infants to enhance nutritional support and growth outcomes.
Background:
Although 90% of babies <1500 g (very-low-birth-weight or VLBW) are appropriate for gestational age (AGA) at birth, almost all are small for gestational age at 36 weeks of gestation, mainly due to nutritional deficiency in the first weeks of life. A computer calculation program (CCP) to calculate parenteral nutrition (PN) was introduced to improve nutritional intake in preterm infants.
Methods:
Somatometric data and composition of PN of VLBW infants were compared with two points of time measured over a period of 4 years.
Results:
Data from 56 patients born before the introduction of the CCP (2001-2002) and 59 patients born after the introduction of the CCP (2004-2005) were obtained. Although the number of AGA infants at birth did not differ, the computer-calculated group had significantly more AGA infants at the time of discharge from hospital (44% vs. 14%, p < 0.05). In this group, more protein and fat were administered in the first 5 days of life (7.3 g/kg vs. 4.5 g/kg, p < 0.05 and 5 g/kg vs. 0.5 g/kg, p < 0.05) and the duration of total PN was shorter (16 days vs. 24 days, p < 0.05).
Conclusion:
Because the CCP contributes to a better weight gain in VLBW infants due to simplification of PN calculation, we suggest its use in the calculation of PN in VLBW infants.
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