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Improved nutrient intake following implementation of the consensus standardised parenteral nutrition formulations in
Srinivas Bolisetty1,2,3, Pramod Pharande4,5, Lakshman Nirthanakumaran6
1Division of Newborn Services, Royal Hospital for Women, Sydney, Australia. Srinivas.bolisetty@sesiahs.health.nsw.gov.au.
Insights
New standardized parenteral nutrition (SPN) formulations improved protein and caloric intake and weight gain in preterm infants. However, day 1 protein intake did not meet the consensus goal.
Area of Science:
- Neonatal Intensive Care Medicine
- Pediatric Nutrition
- Clinical Nutrition
Background:
- Standardized parenteral nutrition (SPN) formulations were implemented in New South Wales neonatal intensive care units in July 2011.
- The implementation followed consensus group recommendations to improve neonatal care.
Purpose of the Study:
- To evaluate the efficacy and safety of new consensus SPN formulations.
- To assess the impact of SPN on preterm infants born before 32 weeks gestation.
Main Methods:
- A before-after intervention study design was employed.
- Data from a post-consensus cohort (2011-2012) were prospectively collected.
- Data were compared retrospectively with a pre-consensus cohort (2010).
Main Results:
- The post-consensus group initiated parenteral nutrition (PN) significantly earlier (6 vs. 11 hours).
- Higher protein (1.34 vs. 0.49 g/kg on day 1) and caloric intake were observed.
- Greater weight gain (285 vs. 220 g) in the first 4 weeks was noted, with reduced fluid and lipid therapy duration.
Conclusions:
- New consensus SPN solutions enhanced protein intake within the first 7 days and promoted greater weight gain in preterm infants.
- Protein intake on day 1 remained below the consensus target of 2 g/kg/day.
Background:
New standardised parenteral nutrition (SPN) formulations were implemented in July 2011 in many neonatal intensive care units in New South Wales following consensus group recommendations. The aim was to evaluate the efficacy and safety profile of new consensus formulations in preterm infants born less than 32 weeks.
Methods:
A before-after intervention study conducted at a tertiary neonatal intensive care unit. Data from the post-consensus cohort (2011 to 2012) were prospectively collected and compared retrospectively with a pre-consensus cohort of neonates (2010).
Results:
Post-consensus group commenced parenteral nutrition (PN) significantly earlier (6 v 11 hours of age, p 0.005). In comparison to the pre-consensus cohort, there was a higher protein intake from day 1 (1.34 v 0.49 g/kg, p 0.000) to day 7 (3.55 v 2.35 g/kg, p 0.000), higher caloric intake from day 1 (30 v 26 kcal/kg, p 0.004) to day 3 (64 v 62 kcal/kg, p 0.026), and less daily fluid intake from day 3 (105.8 v 113.8 mL/kg, p 0.011) to day 7 (148.8 v 156.2 mL/kg, p 0.025), and reduced duration of lipid therapy (253 v 475 hr, p 0.011). This group also had a significantly greater weight gain in the first 4 weeks (285 v 220 g, p 0.003).
Conclusions:
New consensus SPN solutions provided better protein intake in the first 7 days and were associated with greater weight gain in the first 4 weeks. However, protein intake on day 1 was below the consensus goal of 2 g/kg/day.
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