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Published on: September 20, 2019
A triple-chamber parenteral nutrition solution was associated with improved protein intake in very low birthweight
Lotta Immeli1, Pauliina M Mäkelä1, Markus Leskinen1
1Children's Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
Insights
Triple-chamber parenteral nutrition (PN) solutions improved protein intake in very low birthweight (VLBW) infants. This method increased the likelihood of achieving protein targets earlier compared to standard PN regimens.
Area of Science:
- Neonatal nutrition
- Parenteral nutrition
- Infant health
Background:
- Very low birthweight (VLBW) infants (<1500g) require specialized nutritional support.
- Optimizing protein intake is crucial for VLBW infant growth and development.
- Previous parenteral nutrition (PN) methods may not consistently meet protein targets.
Purpose of the Study:
- To evaluate nutrient intakes in VLBW infants.
- To test if a triple-chamber PN solution enhances protein delivery.
- To compare protein and energy intake with different PN regimens.
Main Methods:
- Retrospective cohort study of 953 VLBW infants (born <32 weeks gestation) from 2005-2013.
- Infants grouped by birth year and PN regimen (individual, standard two-in-one, or triple-chamber).
- Nutrient intakes analyzed from computerized medication administration records.
Main Results:
- Triple-chamber PN (2012-2013) increased the likelihood of reaching the target protein intake (3.5g/kg/d) by 3-7 days earlier.
- This group also achieved higher median energy intake (90 kcal/kg/d) in the first week.
- Median protein intakes in weeks 1, 2, and 3 were significantly higher with triple-chamber PN compared to 2005-2011 groups (P<.05).
Conclusions:
- Triple-chamber PN solutions are associated with improved protein delivery in VLBW infants.
- This method enhances the probability of achieving target protein intake.
- The findings support the use of triple-chamber PN for optimizing neonatal nutrition.
Aim:
We evaluated the nutrient intakes of very low birthweight (VLBW) infants weighing less than 1500 g and tested the hypothesis that using a triple-chamber parenteral nutrition (PN) solution, containing lipids, glucose and amino acids, would improve protein intake.
Methods:
This retrospective cohort study comprised 953 VLBW infants born in 2005-2013 at a gestational age of less than 32 + 0/7 weeks and admitted to the neonatal care unit at Helsinki Children's Hospital, Finland. The infants were divided into four groups according their birth year and PN regime. Nutrient intakes were obtained from computerised medication administration records.
Results:
In 2012-2013, when a triple-chamber PN solution was used, infants were more likely to reach the target parenteral protein intake of 3.5 g/kg/d, and reach it 3-7 days earlier, compared with infants who received individual PN or standard two-in-one PN solutions in 2005-2011. In addition, infants in the triple-chamber group had the highest median energy intake (90 kcal/kg/d) during the first week. They also had higher median protein intakes in weeks one, two and three (3.1, 3.4 and 3.7 g/kg/d) than infants born in 2005-2011 (P < .05).
Conclusion:
Using a triple-chamber PN solution was associated with improved protein intake, and the protein target was more likely to be achieved.
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