Central catheter removal timing and growth patterns in preterm infants

Area of Science:

• Neonatalogy
• Pediatric Nutrition
• Growth and Development

Background:

• Early discontinuation of total parenteral nutrition (TPN) at 100 ml/kg/day enteral feeds, versus 140 ml/kg/day, delayed birth weight regain in very low birth weight (VLBW) infants.
• This study investigates the long-term growth implications of early TPN discontinuation up to 2 years corrected gestational age (CGA).

Purpose of the Study:

• To compare the growth parameters (weight, length, occipital-frontal circumference) of VLBW infants based on the timing of TPN discontinuation.
• To assess growth differences up to 2 years corrected gestational age (CGA).

Main Methods:

• A post-trial follow-up study reviewed medical records of VLBW infants from a randomized controlled trial.
• Growth parameters were collected at birth and at five predefined time points up to 96 weeks CGA.
• Z-scores for weight, length, and OFC were calculated and compared between control and intervention groups.

Main Results:

• Lower mean weight Z-scores were observed in the intervention group (early TPN discontinuation) from 0-11 weeks CGA, especially in extremely low birth weight (ELBW) infants, but without statistical significance.
• A statistically significant difference in length Z-scores was found for ELBW infants between 12-35 weeks CGA in the early TPN discontinuation group.
• No significant differences in occipital-frontal circumference (OFC) Z-scores were noted at any time point.

Conclusions:

• Discontinuing TPN at 100 ml/kg/day resulted in significantly lower length Z-scores for ELBW infants between 12-35 weeks CGA.
• Despite initial growth differences, all infants showed comparable Z-scores by 2 years CGA, indicating catch-up growth.