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Parenteral Protein Decision Support System Improves Protein Delivery in Preterm Infants: A Randomized Clinical Trial

Mhd Wael Alrifai1, David P Mulherin2, Stuart T Weinberg1,3

  • 1Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

JPEN. Journal of Parenteral and Enteral Nutrition
|March 6, 2018
PubMed

Insights

The Parenteral Protein Calculator (PPC) improved protein dosing accuracy for preterm infants receiving parenteral nutrition (PN). This clinical decision support system helps optimize protein intake for vulnerable newborns.

Area of Science:

  • Neonatology
  • Clinical Nutrition
  • Medical Informatics

Background:

  • Accurate parenteral protein delivery is critical but complex for preterm infants.
  • Daily adjustments are needed based on infant's age, weight, and enteral intake.
  • Existing methods present challenges in precise protein dosing.

Purpose of the Study:

  • To develop and assess the Parenteral Protein Calculator (PPC).
  • To evaluate the PPC as a clinical decision support system for parenteral nutrition (PN) in preterm infants.
  • To enhance the accuracy of protein administration in this vulnerable population.

Main Methods:

  • A randomized controlled trial compared the PPC to routine care.
  • The PPC was integrated into a computerized provider order entry system.
  • Infants under 3 days old with birth weight ≤1500g were eligible.

Main Results:

  • The PPC group showed significantly more accurate protein dosing (OR=5.8).
  • Absolute deviation from the protein target was reduced by 0.41 g/kg in the PPC group.
  • The study involved 42 infants across 432 total PN days.

Conclusions:

  • The PPC effectively improved protein dosing accuracy for preterm infants on PN.
  • Further research is warranted to assess the impact of such systems on growth and uremia.
  • Replication in other PN nutrient management is suggested.
Abstract

Keywords:
clinical decision support systemmedication dosingparenteral nutritionprotein intakeuremia

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