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Aggressive parenteral nutrition and growth velocity in preterm infants
Almudena Ribed Sánchez1, Rosa Ma Romero Jiménez1, Ma Carmen Sánchez Gómez de Orgaz2
1Servicio de Farmacia. Hospital General Universitario Gregorio Marañón. Madrid. España.. rosa.romero@salud.madrid.org.
Insights
Parenteral nutrition (PN) in preterm infants led to early weight regain and growth rates similar to intrauterine development. Aggressive nutritional support was utilized in this tertiary hospital setting.
Area of Science:
- Neonatology
- Pediatric Nutrition
- Intensive Care Medicine
Background:
- Parenteral nutrition (PN) is crucial for sustaining growth in newborns, presenting a significant therapeutic challenge.
- Optimizing PN practices is essential for improving outcomes in preterm infants.
Purpose of the Study:
- To characterize parenteral nutrition (PN) strategies in a tertiary hospital.
- To evaluate the postnatal growth of preterm infants receiving PN.
Main Methods:
- An observational retrospective study was conducted over three months.
- Data collected included infant demographics, anthropometrics, and daily intake of calories, proteins, and lipids via PN.
- Growth velocity was assessed by average daily weight gain and compared to intrauterine growth rates.
Main Results:
- Sixty-eight preterm infants initiated PN, with a mean gestational age of 33 weeks.
- Seventy-five percent of infants regained birth weight by day 3 of PN, with an average daily weight gain of 16 g/kg/d.
- While growth velocity approximated intrauterine rates, infants born before 30 weeks gestation often did not reach the median birth weight of reference populations.
Conclusions:
- The hospital employs an aggressive parenteral nutrition (PN) approach.
- Preterm infants in this study achieved earlier birth weight regain and exhibited growth velocities comparable to intrauterine rates, outperforming other clinical trials.
Introduction:
Parenteral administration of nutrients to sustain newborns' growth represents an important therapeutic challenge.
Objective:
To describe parenteral nutrition (PN) practices in a tertiary hospital and evaluate postnatal growth in preterm infants.
Material And Methods:
Observational retrospective study over 3 months. Data on infants born or admitted to the Neonatal Department and starting PN were collected. Demographics, anthropometric data, daily caloric, protein intake data and PN components used were collected. Growth velocity was characterized by the average daily weight gain and compared to intrauterine growth.
Results:
68 preterm infants started PN during the study period. Most infants (65%) were born by caesarean and mean gestational age was 33 weeks. Twenty five percent of newborns did not regain birth weight. The remaining 75% regained birth weight on the 3rd day of PN and average daily weight gain was 16 g/kg/d, ranging between 12 and 22 g/kg/d. Although weight gain approximated intrauterine rate, most infants born <30 weeks gestation did not achieve median birth weight of the reference population. Early aggressive PN was administered with an average of 3, 11 and 3 g/Kg/d of proteins, carbohydrates and lipids respectively, reaching a maximum on the 4th day of 4, 18, 4 g/kg/d, respectively.
Discussion:
Aggressive PN is used in the hospital setting. The preterm infants reached birth weight earlier and had a greater velocity of growth than in other clinical trials and similar to intrauterine.
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