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Standardized and Individualized Parenteral Nutrition Mixtures in a Pediatric Home Parenteral Nutrition Population

Sjoerd C J Nagelkerke1, Cora F Jonkers-Schuitema1, Wendy L M Kastelijn2

  • 1Department of Pediatric Gastroenterology, Hepatology and Nutrition, Emma Children's Hospital, University of Amsterdam, Amsterdam UMC, Amsterdam.

Journal of Pediatric Gastroenterology and Nutrition
|January 25, 2020
PubMed

Insights

Standardized parenteral nutrition (PN) showed comparable growth effects to individualized PN in children. Safety outcomes, including electrolyte disturbances, were also similar between standardized and individualized PN. Further research is needed for confirmation.

Area of Science:

  • Pediatric Nutrition
  • Clinical Gastroenterology

Background:

  • Parenteral nutrition (PN) is crucial for children with chronic intestinal failure.
  • Limited data exists comparing standardized PN with individualized PN in pediatric homecare settings.

Purpose of the Study:

  • To evaluate the efficacy and safety of standardized PN versus individualized PN in children receiving home PN.
  • To assess the impact on growth parameters and biochemical/electrolyte balance.

Main Methods:

  • A descriptive cohort study comparing standardized and individualized PN in Dutch children.
  • Primary outcome: growth over 2 years. Secondary outcomes: electrolyte and biochemical abnormalities.
  • Patients were matched for age to control for confounding factors.

Main Results:

  • Standardized PN showed a significant increase in weight-for-age (WFA) compared to a decrease in individualized PN (+0.38 SD vs -0.55 SD).
  • No significant differences were observed in electrolyte disturbances or biochemical abnormalities between the groups.
  • After age-matching, no significant differences in WFA, height-for-age, or weight-for-height changes were found.

Conclusions:

  • Standardized PN mixtures appear to have comparable effects on growth and safety compared to individualized PN in children over 2.5 years old with chronic intestinal failure.
  • Standardized PN with added micronutrients is non-inferior regarding electrolyte and biochemical abnormalities.
  • Larger studies are recommended to validate these findings.
Abstract

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