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The present challenges of parenteral nutrition in preterm infants and children

Johannes B van Goudoever1, Hester Vlaardingerbroek

  • 1Department of Pediatrics, Academic Medical Center-Emma Children's Hospital, Amsterdam, The Netherlands 5Department of Pediatrics, VU University Medical Centre, Amsterdam, The Netherlands.

The Journal of Nutrition
|October 11, 2013
PubMed

Insights

Optimizing parenteral nutrition for preterm infants is crucial for mimicking intrauterine growth and improving outcomes. Early administration of amino acids and lipids is recommended but often not followed, necessitating further research into parenteral solution quality.

Area of Science:

  • Neonatology
  • Pediatric Nutrition
  • Parenteral Nutrition

Background:

  • Preterm infants often experience growth restriction due to suboptimal nutritional management.
  • Current guidelines recommend early and comprehensive nutrient administration, including amino acids and lipids.
  • Adherence to these guidelines in clinical practice remains a significant challenge.

Purpose of the Study:

  • To highlight the importance of parenteral nutrition in achieving intrauterine growth equivalence in preterm infants.
  • To emphasize the need for early and appropriate nutrient delivery to prevent growth deficits.
  • To identify the gap between recommended guidelines and actual clinical practice in neonatal units.

Main Methods:

  • Review of existing guidelines for parenteral nutrition in preterm infants.
  • Analysis of common practices in neonatal intensive care units regarding nutrient administration.
  • Identification of barriers to guideline compliance.

Main Results:

  • Early administration of amino acids and lipids is advised but frequently not implemented from birth.
  • Suboptimal parenteral nutrition contributes to growth restriction in a significant number of preterm infants.
  • Discrepancies exist between established best practices and routine clinical application.

Conclusions:

  • There is a critical need to improve the quality and composition of parenteral solutions for neonates.
  • Enhanced adherence to established nutritional guidelines is essential for better preterm infant outcomes.
  • Further research is required to optimize parenteral nutrition strategies for both neonates and older children.

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