Nutrition Considerations in Neonatal Extracorporeal Life Support

Area of Science:

• Neonatal intensive care
• Pediatric critical care
• Nutritional science

Background:

• Extracorporeal life support (ECLS) is vital for neonates but presents unique nutritional challenges.
• Critically ill neonates on ECLS face high risks of malnutrition, feeding difficulties, and growth failure.
• Existing clinical guidelines are available, but nutritional support practices vary and are often insufficient.

Purpose of the Study:

• To review current knowledge on nutritional requirements and provision for neonates undergoing ECLS.
• To examine current practices, long-term outcomes, and special considerations for nutrition in this population.
• To highlight the need for standardized and aggressive nutritional support.

Main Methods:

• State-of-the-art review of existing literature.
• Examination of nutritional requirements, provision strategies, and clinical practices.
• Analysis of long-term outcomes and special population considerations.

Main Results:

• Nutritional needs in neonates on ECLS are complex and require early, aggressive support.
• Parenteral nutrition remains crucial for meeting protein and overall nutrition goals.
• Long-term complications like feeding difficulties and growth failure are prevalent, especially in congenital diaphragmatic hernia survivors.

Conclusions:

• Aggressive and early nutritional support is essential for neonates on ECLS to mitigate adverse outcomes.
• Recognizing and managing potential complications, including oral aversion and renal issues, is critical.
• Further research and standardized practices are needed to optimize nutrition and improve outcomes for neonatal ECLS survivors.