[Nutritional support in preterm infants]

Area of Science:

• Neonatology
• Pediatric Nutrition
• Clinical Practice

Context:

• Extrauterine growth restriction (EGR) presents a significant clinical challenge for pediatricians, particularly in China.
• Parenteral nutrition (PN) is a critical intervention for infants with EGR, but its optimal delivery and associated risks require careful management.
• Recent advancements in fat emulsions for PN lack robust clinical evidence in premature infants.

Purpose:

• To review the benefits of using peripherally inserted central catheters (PICC) as a route for parenteral nutrition in managing EGR.
• To discuss the current evidence and limitations of new fat emulsions in premature infants.
• To outline strategies for preventing parenteral nutrition-associated liver damage (PNALD).

Summary:

• Peripherally inserted central catheters (PICC) offer advantages for administering parenteral nutrition (PN) in infants with extrauterine growth restriction (EGR).
• Current evidence supporting the use of novel fat emulsions in premature infants is limited, necessitating further clinical trials.
• Preventive measures for parenteral nutrition-associated liver damage (PNALD) include early enteral feeding, optimized caloric intake, and sepsis prevention.

Impact:

• Provides guidance on optimizing PN delivery via PICC for infants with EGR.
• Highlights the need for more research into new fat emulsions for premature infants.
• Emphasizes evidence-based strategies for mitigating serious complications associated with TPN, improving infant outcomes.