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CaxP and Ca/P in the parenteral feeding of preterm infants

P Knight, D Heer, G Abdenour

    JPEN. Journal of Parenteral and Enteral Nutrition
    |March 1, 1983
    PubMed

    Insights

    To prevent fractures and rickets in preterm infants on parenteral nutrition, maintain calcium and phosphate levels. A calcium/phosphate ratio of 3.0 is recommended for safe intravenous feeding solutions.

    Area of Science:

    • Neonatalogy
    • Pediatric Nutrition
    • Biochemistry

    Background:

    • Preterm infants on prolonged intravenous feeding often develop fractures and rickets.
    • Higher calcium intake in infants correlates with fewer fractures.

    Purpose of the Study:

    • Determine maximum calcium and phosphate amounts in parenteral nutrition (PN) without precipitation.
    • Identify optimal calcium to phosphate (Ca/P) ratio in PN solutions for preterm infants.

    Main Methods:

    • In vitro experiments and clinical observations to assess calcium phosphate precipitation.
    • Intake and output studies in preterm infants to evaluate urinary Ca/P losses.

    Main Results:

    • Calcium x Phosphate (CaxP) product should not exceed 75 mM² in silicone catheters and 100 mM² in peripheral IV solutions.
    • A Ca/P ratio of 5.0 minimized urinary calcium and phosphate losses.
    • A Ca/P ratio of 3.0 is suggested as a safer compromise for long-term PN.

    Conclusions:

    • Balancing calcium and phosphate in PN is crucial for preterm infants.
    • A Ca/P ratio of 3.0 offers a safer approach, mitigating risks of both phosphate deficiency and calcium deficiency-related bone issues.

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