Parenteral nutrition customization in pediatrics: A descriptive cohort study

Area of Science:

• Pediatric Nutrition
• Clinical Nutrition
• Medical Nutrition Therapy

Background:

• Parenteral nutrition (PN) is a complex therapy requiring careful individualization, especially in vulnerable pediatric populations.
• Standard PN formulations may not meet the unique metabolic and clinical needs of hospitalized children.
• Understanding the specific reasons for PN customization is vital for optimizing patient outcomes and resource allocation.

Purpose of the Study:

• To analyze the primary indications for customizing parenteral nutrition (PN) in pediatric patients admitted to a quaternary care hospital.
• To identify the frequency and timing of PN customization requirements in this population.

Main Methods:

• A descriptive cohort study was conducted involving 264 hospitalized pediatric patients receiving PN.
• Data collected included anthropometric, biochemical, and hospitalization details from patient records.
• Customization reasons were defined as conditions precluding standard adult/teenager PN, including renal/liver failure, energy-protein needs, and mineral/triglyceride abnormalities.

Main Results:

• The majority of patients (87.9%) required customized PN within 48 hours, primarily for energy-protein adequacy.
• Mineral disturbances became a significant reason for further PN individualization within the first 4 days.
• High rates of customization were observed throughout the first week of PN therapy (97.4% at 48h, 96.2% at day 4, 90.1% at day 7).

Conclusions:

• Customized PN is essential for pediatric patients, particularly those who are younger, malnourished, or in intensive care.
• The findings underscore the importance of a Nutritional Multidisciplinary Therapy Team.
• Implementation of a dedicated electronic system for PN prescription is recommended to enhance safety and efficiency.